Impact of RapidAI mobile application on treatment times in patients with large vessel occlusion

Abstract

BackgroundCurrent efforts to reduce door to groin puncture time (DGPT) aim to optimize clinical outcomes in stroke patients with large vessel occlusions (LVOs). The RapidAI mobile application (Rapid Mobile App) provides quick access to perfusion and vessel imaging in patients with LVOs. We hypothesize that utilization of RapidAI mobile application can significantly reduce treatment times in stroke care by accelerating the process of mobilizing stroke clinicians and interventionalists.MethodsWe analyzed patients presenting with LVOs between June 2019 and October 2020. Thirty-one patients were treated between June 2019 and March 2020 (pre-app group). Thirty-three patients presented between March 2020 and October 2020 (post-app group). Mann–Whitney U test and Kruskal–Wallis tests were used to examine variables that are not normally distributed. In a secondary analysis we analyzed interhospital time metrics between primary stroke centers and our comprehensive stroke center.ResultsBaseline demographic and vascular risk factors were similar in both groups. Use of Rapid Mobile App resulted in 33 min reduction in DGPT (P=0.02), 35 min reduction in door to first pass time (P=0.02), and 37 min reduction in door to recanalization time (P=0.02) in univariate analyses when compared with patients treated pre-app. In a multiple linear regression model, utilization of Rapid Mobile App significantly predicted shorter DGPT (P=0.002). In an adjusted model, National Institutes of Health Stroke Scale (NIHSS) 24 hours after procedure and at discharge were significantly lower in the post-app group (P=0.03). Time of transfer between primary and comprehensive stroke center was comparable in both groups (P=0.26).ConclusionIn patients with LVOs, the implementation of the RapidAI mobile application was independently associated with reductions in intrahospital treatment times.

Head-to-head comparison of commercial artificial intelligence solutions for detection of large vessel occlusion at a comprehensive stroke center

“…One limitation of this study is that we did not evaluate the impact of these tools on clinical outcomes. Other studies have previously shown a significant improvement in transfer times of LVO patients (10), but there are mixed results at comprehensive stroke centers (9,(11)(12)(13). This study included a relatively small sample size at a single institution which may limit generalizability.…”

Optimizing Door-to-Groin Puncture Time: The Mayo Clinic Experience

“… 31 Another innovative development has been the use of the mobile application RapidAI, which analyzes the imaging of patients to detect LVOs and results in significantly lower DTP times. 32 …”

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“…Finally, the latest generation of software has been tested to quantitatively determine ASPECTS and infarct volumes 55 56. However, based on recent publications which showed that more simplified methods to triage late window patients for EVT might be as accurate as advanced imaging,57–59 it is reasonable to suggest that incorporating FPCT not only optimizes patient selection in the early window but may also expand DTAS strategy to late window patients at centers where FP technology is available.…”