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Abstract Application
The related main theme: A. Stroke and Cerebral vascular disorders

Use smartphone application to save life in patients of acute ischemic stroke

Authers:

Sheng-Ta  Tsai, MD 1 , Wei-Chung  Wang, MD 1 , Wei-Shih  Huang, MD 1 , Wei-Ling  Kung, MD 1 , 
1 Neurology Department, China Medical University Hospital, Taichung, Taiwan
Corresponding Author:

Chon-Haw  Tsai

keywords: stroke; smartphone; application; thrombectomy; time; Line
Abstract for original article

OBJECTIVES /BACKGROUND:
In 2019, cerebrovascular accident is the first cause of disability in Taiwan. And the large artery occlusion is one of the devastating events among cerebrovascular accident. In 2015, five big clinical trials confirmed the strong benefit of intra-arterial thrombectomy for these patients. But the thrombectomy is highly technic and facility-dependent procedure, especially to maintain 24-hour available service. In central Taiwan, only few hospital (China Medical University Hospital) can achieve this whole-day thrombectomy treatment, including our hospital. So many surrounding hospitals transfer their large artery occlusion patients to our hospital, with increasing transfer number since 2017. But we found doctors and nurses waste lots of time in communication during interhospital transfer. We started to use smartphone application, “LINE”, to solve this problem.

MATERIAL and METHOD:
We used smartphone application, “LINE” to create a security platform for interhospital transfer communication. We did retrospective chart review of these transfer patients. We started to use “LINE” since January 2018. So we chose the period of May 2017 to December 2017 as baseline. Then compare the characteristics and outcome of thrombectomy patients in 2018 and 2019.

RESULT:
After used the smartphone application, the number of transfer patients greatly increase, from 63 patients in 2017, to 113 patients in 2018, then 175 patients in 2019. And the door to puncture time of these transfer patients decreased, from 109 minutes (2017), to 102 minutes (2018), then 92 minutes (2019), P value= 0.041 (by one way ANOVA in SPSS software). And the percentage of good outcome (90-day modified Rankin Scale= 0, 1, 2) patients after thrombectomy increase, from 11.4% to 21.7%.

DISCUSSION:
Smartphone application as “LINE” enhance the interhospital communication. And thus speed up the door to puncture time and improved the outcome in three months.


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