3. Szekció: Mesterséges intelligencia
Bence Gunda1, Ain Neuhaus2, Ildikó Sipos1, Rita Stang1, Péter Pál Böjti 1, Dániel Bereczki1, Balázs Kis 3, István Szikora3, George Harston2
1. Department of Neurology, Semmelweis University, Budapest, Hungary
2. Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
3. National Centre for Clinical Neurosciences, Budapest, Hungary
Patient selection for reperfusion therapies requires significant expertise in neuroimaging. Increasingly, machine learning based analysis is used for faster, standardized and more accurate patient selection. However, there is little information on how such software influences real-world patient management. We evaluated changes in thrombolysis and thrombectomy delivery following implementation of automated analysis at a high volume primary stroke centre.
We retrospectively collected data on stroke patients admitted to a large university stroke centre from two identical seven-month periods in 2017 and 2018 between which the e-Stroke Suite (Brainomix, Oxford, UK) was implemented to analyse non-contrast CT and CT angiography results. Delivery of stroke care was otherwise unchanged. We collected the number of patients receiving intravenous thrombolysis and/or thrombectomy, the time to treatment; and outcome at 90 days for thrombectomy.
399 patients from 2017 and 398 from 2018 were included in the study. From 2017 to 2018 thrombolysis rates increased from 11.5% to 18.1% with a similar trend for thrombectomy (2.8% to 4.8%). There was a trend towards shorter door-to-needle times (44 to 42 minutes) and CT-to-groin puncture times (174 to 145 minutes). There was a non-significant trend towards improved outcomes with thrombectomy. Qualitatively, physician feedback suggested that e-Stroke Suite increased decision-making confidence and improved patient flow.
Use of artificial intelligence decision support in a hyperacute stroke pathway facilitates decision-making and can improve rate and time of reperfusion therapies a hub-and-spoke system of care.