Abstract DP159: Impact of Interpreter Use on Door-to-Needle Times in Acute Stroke Evaluations Across a Large, Multi-State, TeleStroke Network

Background: Door-to-Needle (DTN) times for thrombolytic administration in ischemic stroke are a critical determinant of functional outcomes. TeleStroke has been effective in reducing ethnic disparities, but the impact of language interpretation services (IS) on DTN times has not been investigated. Methods: All acute stroke evaluations by TeleSpecialists, LLC neurologists from January to December 2024 were extracted from theTeleSpecialists TeleStroke RegistryTM . Patients were divided into two groups based on if IS was used during the evaluation. Baseline characteristics, preferred language, and interpretation method types were collected. DTN and door-to-neuro intervention (NIR) notification times (in minutes) were compared. Results: Among the 117,382 patients included, 2,795 (2.4%) required IS. There were no clinically significant differences in age, gender, or stroke severity between groups. Hispanic ethnicity (83.6%) and use of the Spanish language (69.7%) were the most common in the IS group. Professional IS were used in 73.4% of cases, via audio/visual equipment (37.2%) or in-person (41.2%) methods. DTN times were shorter in the non-IS group (41.00 [30.00, 55.00]) than in the IS group (45.50 [32.00, 62.00], p = 0.0165). A trend towards faster door-to-NIR notification times was observed in the non-IS group (49.0 [35.00, 72.00] vs 54.5 [40.25, 84.50], p = 0.09) for large vessel occlusions. Conclusion: Interpreter use was associated with an increase in DTN times (4.50 minutes). While statistically significant, the clinical impact may be limited. These findings underscore the need to streamline interpreter workflows to reduce delays in time-sensitive acute stroke care, especially in linguistically diverse populations. Future research should explore strategies to enhance communication efficiency while maintaining care quality.