Acute stroke is a common presentation to our radiology department as a primary neuro-intervention centre(1). With the advent of primary endovascular intervention with mechanical thrormbectomy, timely and appropriate imaging has become even more of a cornerstone of acute stroke management. In particular Computed Tomography (CT) Angiography and Perfusion have emerged as routine imaging studies (2) performed in these settings with an associated increase in workload Appropriate coding of imaging during the acute phase allows for the acute imaging to be performed appropriately and recorded for...

We conducted an audit of all studies recorded as “code stroke over a four month period from May to September 2019 to assess for appropriate coding of these cases. Initial data was obtained through our local computerised ordering system (IMPAX RIS). All neurological CT studies performed during the above period were collated and further filtered for those coded as “Code Stroke”. These code stroke studies were individually assessed to ascertain which cases proceeded to have further imaging studies, either angiography and perfusion and whether these...

180 number of studies recorded as “Code Stroke” during the period investigated. Three separate codes were found to exist for this scenario – “CT Code Sroke Brain”, and “Ct Code Stroke Protocol”. Of these 180 cases, 104 went on to undergo CT Carotid, Vertebral and intracranial angiography. 18 of the 104 (17%) (fig 1.) Angiographic studies were not coded for on the RIS system. 25 of the original 180 code stroke studies were found to have undergone CT Perfusion. 4 of 25 (16%) (fig 2.)...

Our audit estabilished that approximately 17% of Angiographic and 16% of perfusion imaging performed in the setting of an emergent stroke work-up did not have appropriate coding and were thus not recorded as having been performed in our data. In effect, almost one fifth of the imaging performed in the setting of acute stroke was found to be undocumented. As the emergent nature of these cases means they displace planned inpatient and outpatient cases, this has serious implications for departmental planning, funding and workflow. Significant...

P. Kennedy; Cork/IE - nothing to disclose G. Wyse; Cork/IE - nothing to disclose

1.CTA-for-All: Impact of EmergencyComputedTomographicAngiographyfor All Patients WithStrokePresenting Within 24 Hours of Onset. Mayer et al . Stroke.2020 Jan;51(1):331-334. doi: 10.1161/STROKEAHA.119.027356. Epub 2019 Nov 5. 2.https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/stroke-model-of-care.pdf 3.https://www.hse.ie/eng/about/who/cspd/ncps/stroke/resources/2018-national-stroke-register-report.pdf