Pilot study of a Stroke Same Day Emergency Care Unit (SDEC) on reducing stroke mimic admissions and improving treatment times for stroke and TIA patients

Marigold, R, Weir, N., Mavrokordatos, C., Evans, S., Battersby Wood, E., Crawford, P., Price, E and Brown, V (2025) Pilot study of a Stroke Same Day Emergency Care Unit (SDEC) on reducing stroke mimic admissions and improving treatment times for stroke and TIA patients. International Journal of Stroke, 20 (3S), 16. (doi:10.1177/17474930251379781).

Abstract

Introduction: University Hospital Southampton saw 4500 referrals and
1250 stroke patients in 2024 with numbers rising at 15% and 10% per
year respectively As a regional 24/7 thrombectomy centre we needed a
strategy to mitigate this demand and avoid non stroke admissions, A 6
week stroke same day emergency care unit (SDEC) pilot reviewed
patients with TIAs, suspected stroke mimics and those with minor
symptoms
Method: Patients with a low probability of stroke, minor symptoms or
TIA were seen on SDEC rather than HASU. Other patients with more
significant stroke symptoms were sent to HASU. We had same day access
to phlebotomy, ECG and CT / MRI scanning. We assessed the impact on
HASU admissions, time to imaging and to TIA clinic from referral and
length of stay.
Results or details of the case: 141 patients were seen on SDEC, 65 in
TIA clinic and 76 from ED. 152 patients were admitted to HASU. 55
SDEC patients (33%) avoided an unnecessary HASU admission, 85% were
discharged the same day. Mean time to MRI on SDEC was 2hrs15min,
time to CT 55min and visit time 4hrs14min. 50% TIAs seen within 72hrs.
Door to HASU admission was 55min quicker, length of stay 0.9 days
shorter and bed occupancy rates 20% lower.
Conclusion: The SDEC reduced HASU admissions by a third, speeding
up treatment times and reducing inpatient length of stay. The pilot enabled
us to treat mimics and TIAs more quickly and efficiently simultaneously
creating more HASU bed capacity for local stroke patients our
regional thrombectomy service.

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