Googling location for operating base of mobile stroke unit in metropolitan Sydney

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background and purpose: The recent advances in stroke therapy have placed focus on delivering care within the first hour after stroke onset (golden hour), principally through the use of Mobile Stroke Unit (MSU) to bring the hospital to the patient. The aim of this project is to search the location of MSU hub in Sydney, Australia, optimizing for catchment, transport to nearest thrombolysis and endovascular clot retrieval (ECR)/thrombectomy capable hospital and population at risk. Methods: Traveling time was performed using ggmap package in R to interface with Google Maps application program interface (API). This analysis estimates the travel time fromthe centroids of each suburbs to five potentialMSU hubs (Royal Prince Alfred, Prince ofWales, Royal North Shore, Liverpool, andWestmead hospitals) and eight thrombolysis capable hospitals. It is proposed that the MSU should be deployed at ECR hub to cover the suburbs, not well-covered by thrombolysis and ECR capable hospitals. This step was performed by assigning membership to hospitals within 30min traveling time to the ECR hub. The base hub of the MSU was proposed as the closest hub (providing ECR) to the least well-served suburbs. The population serviceable by MSU was estimated using stroke incidence studies in Melbourne and Adelaide. Results: The largest population, serviceable byMSU within 30min (4,606 cases), 45min radius (8,918 cases), and 60min (10,084 cases), was Royal North Shore followed by Royal Prince Alfred, Liverpool,Westmead, and Prince ofWales hospitals. Prince ofWales hospital has the smallest catchment within 30min (3,078 cases), 45min (7,721 cases), and 60min (9,984 cases). Suburbs at the edge of metropolitan Sydney such as the Northern Suburbs are less well-served by thrombolysis and ECR capable hospitals. There are 10 suburbs within 30min travel of one hospital. The remainders are within 30min of two or more hospitals. Conclusions: Any of the five endovascular clot retrieval capable hospitals are capable of serving as a hub for MSU. We provide a method to identify the hub based on location of suburbs less well-served by other hospital.

Original languageEnglish
Article number810
Number of pages6
JournalFrontiers in Neurology
Volume10
Issue numberJUL
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Endovascular clot retrieval
  • Google maps
  • Mobile stroke unit
  • Optimization
  • Stroke

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