Abstract TP125: Interpreter Requirements Needed For Tpa Evaluations And Resulting Performance (INTERP)

Introduction: Acute ischemic stroke (AIS) patients requiring interpreter services during an acute stroke code can experience care delays. Prior research has shown no differences in door-to-needle times in non-English fluent patients. The purpose of this study was to examine the influence of interpreter service needs (IS) on time metrics of tPA administration. Methods: We retrospectively reviewed prospectively collected data from our Comprehensive Stroke Center database (1/2011-4/1/2021) and EMR. Subjects with a discharge diagnosis of AIS for whom a “stroke code” was activated were included; in-house strokes were excluded. Baseline characteristics, frequency of tPA, tPA exclusions, NIHSS, and tPA time metrics were compared between patients who did or did not require IS. Analyses utilized ANOVA, t Test, or Pearson’s Chi-squared test as appropriate. Results: Of 1,043 patients with AIS, 41 had a documented need for IS. tPA was administered in 9 IS and 322 non-IS patients. In IS patients, there were no differences in baseline characteristics between those who received tPA and those who did not. In patients who received tPA, there was a larger amount of Hispanic ethnicity (p<0.01) and hyperlipidemia (p=0.02) in patients requiring IS. There were no tPA rate differences between those that did not and did require IS (22% vs 32%; p=0.22). Patients excluded from tPA due to being out of the window were more likely to have required IS (35% vs 59%; p = 0.003). Onset to arrival (p = 0.89), arrival to treatment decision (p = 0.85), door to needle (p=0.41), and onset to treatment (0.41) were not different in IS patients. Median NIHSS was not different overall (p=0.70) or in tPA patients (p=0.36). Conclusions: This study found no significant difference in frequency or time metrics of tPA administration in AIS patients requiring interpreter services during an acute stroke code. If a patient required an interpreter, they were more likely to be excluded from tPA on the basis of time. We hypothesize this is due to increased time required to obtain relevant history or exam data or small sample size. Further work is planned in larger data sets to ensure resource availability to patients who are in need of interpreter services.