ABSTRACT NUMBER: ESOC2026A1346 THE EFFECT OF STROKE CODE PROTOCOL IN THE EMERGENCY DEPARTMENT ON CLINICAL OUTCOMES OF ACUTE INTRACEREBRAL HEMORRHAGIC PATIENTS: SINGLE CENTER ANALYSIS

Abstract Background and aims The stroke code protocol is shown to improve prognosis in acute ischemic stroke(AIS) patients. In hemorrhagic stroke patients, rapid blood pressure control can reduce mortality and morbidity. This study investigated the effect of stroke code protocol on triage and clinical outcomes in patients presenting with intracranial hemorrhage(IH). Methods In our center, stroke code protocol is applied for all stroke suspected patients upon emergency department(ED) admission. Patients admitted to our center with acute stroke between 2020–2024 and diagnosed with IH were evaluated. Door-to-imaging, door-to-treatment, door-to-admission times were recorded. Door-to-treatment was referred as door to start of anti-hypertensive treatments. Clinical outcomes were assessed using 24-hour NIHSS scores and 3-month mRS scores. Results 107 patients were included in the study. The most common risk factor was hypertension, present in 96% of cases. Intravenous nicardipine was initiated for 88% of patients. The mean onset-to-door time was 79.6 minutes, door-to-imaging time was 13.4, and door-to-antihypertensive treatment time was 47 minutes. The average GCS at admission was 13, and NIHSS was 10.3. The average 24-hour NIHSS was 8.8. The average 3-month mRS was 3.3, and mRS 6 was in 36% of cases. Conclusions Door-to-imaging and door-to-antihypertensive treatment times were relatively short in patients via the stroke code protocol. The lack of increase in NIHSS scores at 24 hours and the low mortality rate may be associated with rapid intervention processes. The establishment of stroke-code and anti-hypertensive therapy initiation in ED are approaches that should be integrated in acute care of IH. Conflict of interest Arsida Bajrami: nothing to disclose, Erensu Mengüşoğlu:nothing to disclose, Sena Aksoy:nothing to disclose, Songül Şenadım:nothing to disclose, Serdar Geyik:nothing to disclose