291. Epidemiology of Candidemia Rates during COVID-19 and Comparison of Outcomes in Candidemia Between COVID-19 and Non-COVID-19 Patients

Abstract Background Fungemia is associated with high rates of morbidity, mortality and increase in length of hospital stay. Several studies have recognized increased rates of candidemia since the COVID-19 pandemic. Methods A retrospective cohort study was conducted at a tertiary healthcare system in Detroit, Michigan to evaluate the impact of the COVID-19 pandemic on incidence of candidemia. The “pre COVID-19” timeframe was defined as January – May 2019 while the “during COVID-19” timeframe was January – May 2020. To compare incidence and patient characteristics between cohorts, t-tests and chi-square analysis was used. Additional sub-analysis was performed in candidemia patients during COVID-19 timeframe comparing outcomes of patients based on COVID-19 status. A Fisher Exact and Satterthwaite Test were used for analysis of categorical and continuous variables, respectively. Results Overall, 46 cases of candidemia were identified in both the pre COVID-19 and during COVID-19 periods. Pre COVID-19, the average number of cases was 3.0 ± 1.2 per month. The incidence more than doubled during COVID-19 to 6.2 ± 4.2 cases per month (p = 0.14) (Figure 1). No significant differences in patient demographics were detected between cohorts, however, patients in the COVID-19 cohort had higher rates of corticosteroid use, mechanical ventilation and vasopressors (Table 1). In the 2020 period, 31 patients developed candidemia and 12 (38.7%) patients tested SARS-CoV-2 positive. On average, COVID-19 patients developed candidemia 12.1 days from admission, compared to 17.8 days in the COVID-19 negative cohort (p = 0.340). Additionally, COVID-19 patients with candidemia coinfection were significantly more likely to expire; 83.3% (n=10) COVID-19 patients expired compared to 36.8 (n=7) in the COVID-19 negative cohort (p = 0.025) (Table 2). Figure 1. Incidence of Candidemia in the Pre-COVID-19 (January 2019 – May 2019) and During COVID-19 (January 2020-May 2020) periods Table 1. Characteristics of Candidemia patients in the pre-COVID (January 2019-May 2019) and during-COVID periods (January 2020-May 2020) Table 2. Characteristics of Candidemia patients in the SARS-COV-2 negative and SARS-COV-2 positive cohorts from January 2020-May 2020 Conclusion The prevalence of fungemia markedly increased during the COVID-19 surge. Increased use of corticosteroids and broad spectrum antimicrobials, prolonged use of central venous catheters and prolonged ICU length of stay likely contributed to this increase. Patients who developed candidemia co-infection with COVID-19 were found to have poorer outcomes as compared to those who were SARS-CoV-2 negative or untested. Disclosures All Authors: No reported disclosures

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Comparison of Outcomes in Candidemia Between COVID-19 and Non–COVID-19 Patients

Antimicrobial Stewardship & Healthcare Epidemiology ◽

10.1017/ash.2021.112 ◽

2021 ◽

Vol 1 (S1) ◽

pp. s58-s58

Author(s):

Angela Beatriz Cruz ◽

Jennifer LeRose ◽

Teena Chopra

Keyword(s):

Chart Review ◽

Length Of Hospital Stay ◽

Hospital Management ◽

Central Venous Catheters ◽

Causative Organism ◽

Continuous Variables ◽

Central Venous ◽

Patient Demographics ◽

Icu Length Of Stay ◽

Medical Chart Review

Background: Fungemia is associated with high rates of morbidity, mortality, and increase in length of hospital stay. Several studies have recognized increased rates of candidemia since the COVID-19 pandemic. Methods: Patients with candidemia during January through May 2020 were identified through Theradoc. Patient demographics, comorbidities, hospital management, and microbiology were extracted by medical chart review. Patients were divided into cohorts based on COVID-19 status. The Fisher exact and Satterthwaite tests were used for analyses of categorical and continuous variables, respectively. Results: Overall, 31 patients developed candidemia and 12 (38.7%) patients tested SARS-CoV-2 positive. Candida glabrata was the most prevalent causative organism in both groups. On average, COVID-19 patients developed fungemia 12.1 days from admission, compared to 17.8 days in the COVID-19 negative or untested cohort (P = .340). Additionally, COVID-19 patients with a fungemia coinfection were significantly more likely to expire; 10 COVID-19 patients (83.3%) died, compared to 7 (36.8%) in the COVID-19–negative or untested cohort (P = .025). The cohorts did not demonstrate statistically significant differences in terms of demographic, comorbidities, hospital management, or coinfections. Conclusions: The prevalence of fungemia in COVID-19 patients is significantly greater than historically reported figures. Known risk factors for candidemia, such as use of corticosteroid, use of central venous catheters, and prolonged ICU length of stay were higher in the SARS-CoV-2–positive cohort in this period, which likely contributed to increased fungemia rates, as these factors are also more pronounced in those with COVID-19. Patients who developed candidemia in the COVID-19 cohort had poorer outcomes than those who were SARS-CoV-2 negative or were untested. Further investigation should be conducted in larger studies.Funding: NoDisclosures: None

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Anticoagulation in cancer patients in hospice

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e20509 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e20509-e20509

Author(s):

H. M. Holmes ◽

K. T. Bain ◽

R. Luo ◽

A. Zalpour ◽

E. Bruera ◽

...

Keyword(s):

Cancer Patients ◽

Patient Characteristics ◽

Categorical Variables ◽

Continuous Variables ◽

Length Of Service ◽

Chi Square ◽

Patients With Cancer ◽

Hospice Patients ◽

The Mean ◽

The Impact

e20509 Background: Low-molecular weight heparin (LMWH) is preferred over warfarin in patients with thromboembolic disease and active cancer, but no guidelines exist in hospice. Although warfarin may be less safe in hospice patients, hospices may prefer to provide warfarin due to lower cost and less invasiveness compared to LMWHs. We sought to identify disparities in the use of warfarin vs. LMWHs in cancer patients enrolled in hospice. Methods: We analyzed a dataset from a national pharmacy provider for more than 800 hospices. We identified patients with a terminal diagnosis of cancer who were enrolled and died in hospice in 2006 and who were prescribed warfarin or LMWH. Patient characteristics included age, gender, race, cancer diagnosis, length of hospice service, and number of comorbidities. For descriptive comparisons, the Kruskal-Wallis test was used for continuous variables, and the Chi-square test was used for categorical variables. Results: Of 54,764 patients with cancer admitted and deceased in 2006, 3874 (7.1%) were prescribed warfarin, and 1137 (2.1%) were prescribed LMWH. Patients prescribed warfarin (n=576) or enoxaparin (n=5) for treatment of atrial arrhythmias were excluded. The mean age was 70.6 years for warfarin and 64.8 years for LMWH (p<0.0001). The mean and median lengths of service, respectively, were 43.6 days and 23.0 days for warfarin and 35.0 and 18.0 days for LMWH, (p<0.0001). There were no differences for gender, and a higher proportion of white patients were prescribed warfarin. Patients prescribed warfarin had an average of 2.1 comorbid conditions, versus 1.6 conditions for LMWH (p<0.0001). Cancer diagnoses were significantly different between the two groups, with a higher proportion of patients with lung and prostate cancer taking warfarin. Conclusions: Patients prescribed warfarin were older, had more comorbidities, and a longer length of service than patients prescribed LMWHs. Further research is needed to determine the impact of anticoagulation on outcomes, especially cost and quality of life, for cancer patients in hospice. This study raises the need to establish guidelines for the appropriateness of anticoagulation in hospice patients with cancer. No significant financial relationships to disclose.

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Abstract TP231: Every IV Thrombolysis Case Should be Less Than 45 Minutes: Not So Easy All the Time

Stroke ◽

10.1161/str.48.suppl_1.tp231 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Sean Cavanaugh ◽

Jennifer Williams ◽

Andria Ford ◽

Peter Panagos ◽

Laura Heitsch

Keyword(s):

Tertiary Care ◽

Patient Characteristics ◽

Analysis Data ◽

Time Of Arrival ◽

Continuous Variables ◽

Chi Square ◽

Stroke Registry ◽

Significant Difference ◽

Chi Square Analysis ◽

Ed Crowding

Background: Target Stroke establishes the goal to administer IV Alteplase within 60 minutes of ED arrival. High-performing centers frequently treat within 45 minutes. Median door-to-needle (DTN) times at our tertiary care academic hospital are consistently < 30 minutes. Monthly case reviews investigate factors associated with DTN times greater than 45 minutes. Methods: Utilizing our stroke registry, patients treated with Alteplase from 2013-2015 were identified. Baseline demographics, medical comorbidities, weekend or after hours (7PM-7AM) presentation, initial NIHSS, initial BP greater than 185/110 and management, posterior circulation symptoms and ED crowding using the National Emergency Department Overcrowding Scale (NEDOCS) were extracted. Arrival date and time of arrival were cross-referenced with NEDOCS. Patients were divided into cohorts of treatment less than 45 minutes vs. greater than 45 minutes. Continuous variables were tested for normal distribution using Shapiro-Wilk, then either an unpaired t test or Wilcoxon’s test was applied to test for significance. Dichotomous variables were tested for significance with Chi-square analysis. Results: A total of 239 patients were included in the analysis. Data is presented in Table 1. After adjusting for multiple comparisons, there was a statistically significant difference in the distribution of baseline NIHSS scores (p=0.0006), diabetes (p=0.0023), and minor strokes (NIHSS less than 3, p=0.0003). Conclusion: Diabetics and patients with minor symptoms are more likely to have longer DTN times. Elevated BP, ED crowding, weekend and after hour arrivals do not significantly delay evaluation and treatment. While not significant after adjusting for multiple tests, both posterior stoke recognition and method of treating BP should be scrutinized as they are modifiable risk factors. Future awareness of discrete patient characteristics may help identify patients at risk for prolonged DTN.DTN.

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Sampling bias created by ampicillin in isolation media forAeromonas

Canadian Journal of Microbiology ◽

10.1139/w06-103 ◽

2007 ◽

Vol 53 (1) ◽

pp. 39-44 ◽

Cited By ~ 7

Author(s):

Jennifer R Huddleston ◽

John C Zak ◽

Randall M Jeter

Keyword(s):

Sampling Bias ◽

Aeromonas Species ◽

Aquatic Environments ◽

Selective Agent ◽

Opportunistic Pathogens ◽

Chi Square ◽

Isolation Medium ◽

Ability To Act ◽

Chi Square Analysis ◽

The Impact

Members of the bacterial genus Aeromonas are widely isolated from aquatic environments and studied in part for their ability to act as opportunistic pathogens in a variety of animals. All aeromonads, with the exception of Aeromonas trota, are generally thought to be resistant to ampicillin, so the antibiotic is frequently added to isolation medium as a selective agent. In this study, 282 aeromonads from environmental sources were isolated on a medium without ampicillin and their resistance to ampicillin determined. Of the 104 of these isolates that were judged to be independent (nonredundant), 18 (17.3%) were susceptible to ampicillin. A chi-square analysis was performed to determine the impact of ampicillin use on enumerating Aeromonas species from environmental samples. Our results indicate that, when ampicillin is used as a selective agent, a significant portion of the aeromonad population in at least some environ ments can be omitted from isolation.Key words: Aeromonas, ampicillin, selective media.

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Palliative Radiotherapy Within the Veterans Health Administration: Barriers to Referral and Timeliness of Treatment

JCO Oncology Practice ◽

10.1200/op.20.00981 ◽

2021 ◽

pp. OP.20.00981

Author(s):

Ruchika Gutt ◽

Sheetal Malhotra ◽

Michael P. Hagan ◽

Steve P. Lee ◽

Katherine Faricy-Anderson ◽

...

Keyword(s):

Palliative Radiotherapy ◽

Veterans Health Administration ◽

Cord Compression ◽

Veterans Health ◽

Radiation Oncologist ◽

Health Administration ◽

Chi Square ◽

Palliative Radiation Therapy ◽

Chi Square Analysis ◽

The Impact

PURPOSE: Most Veterans Health Administration hospitals do not have radiation oncology (RO) departments on-site. The purpose of this study is to determine the impact of on-site RO on referral patterns and timeliness of palliative radiation therapy (PRT). MATERIALS AND METHODS: A survey was sent to medical directors at 149 Veterans Health Administration centers. Questions evaluated frequency of referral for PRT, timeliness of RO consults and treatment, and barriers to referral for PRT. Chi-square analysis was used to evaluate differences between centers that have on-site RO and centers that refer to outside facilities. RESULTS: Of 108 respondents, 33 (31%) have on-site RO. Chi-square analysis revealed that RO consult within 1 week is more likely at centers with on-site RO (68% v 31%; P = .01). Centers with on-site RO more frequently deliver PRT for spinal cord compression within 24 hours (94% v 70%; P = .01). Those without on-site RO were more likely to want increased radiation oncologist involvement (64% v 26%; P < .001). Barriers to referral for PRT included patient ability to travel (81%), patient noncompliance (31%), delays in consult and/or treatment (31%), difficulty contacting a radiation oncologist (14%), and concern regarding excessive number of treatments (13%). Respondents with on-site RO less frequently reported delays in consult and/or treatment (6% v 41%; P < .0001) and difficulty contacting a radiation oncologist (0% v 20%; P = .0056) as barriers. CONCLUSION: Respondents with on-site RO reported improved communication with radiation oncologists and more timely consultation and treatment initiation. Methods to improve timeliness of PRT for veterans at centers without on-site RO should be considered.

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Abstract P841: The Impact of a Dedicated Pediatric Stroke Discharge Plan Upon Parent Preparedness for Clinic: Before and After the Start of Covid-19

Stroke ◽

10.1161/str.52.suppl_1.p841 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Cindy Nederveld ◽

Vivian Thompson ◽

Jacqueline Murray ◽

Jennifer L Armstrong ◽

Megan Barry ◽

...

Keyword(s):

Multidisciplinary Care ◽

Clinic Visit ◽

Outpatient Setting ◽

Pediatric Stroke ◽

Chi Square ◽

Discharge Plan ◽

Before And After ◽

Appointment Time ◽

Chi Square Analysis ◽

The Impact

Background: The Colorado Pediatric Stroke Program provides comprehensive, multidisciplinary care for pediatric stroke patients and their families. The team, which includes dedicated inpatient and outpatient nurse coordinators, instituted a plan to support the transition from the inpatient to outpatient setting. Purpose: A survey was used to determine family preparedness for clinic and ease of scheduling their appointment. The data were collected before and after enacting remote scheduling and telehealth visits due to the COVID-19 pandemic. Methods: Our team provided educational materials and an outpatient appointment time to families at time of discharge starting in 2019. In January 2020, the stroke clinic staff surveyed parents and guardians about their preparedness for clinic. Telehealth encounters were initiated due to COVID-19 in March 2020, with staff conducting RedCAP surveys by telephone. The survey measured several components of visit preparedness and satisfaction including: understanding of diagnosis, reason for referral prior to clinic visit, familiarity with the stroke team prior to clinic visit, and ease in appointment scheduling. We compared results before and after March 2020 via two-tailed chi-square analysis or two-tailed Fischer’s test. Results: Prior to telehealth, families favorably reported responses with 92% (47/52) knowing the reason for referral, 86% (42/49) receiving educational material prior to clinic, and 84% (42/50) reporting familiarity with our team. All patients (50/50) reported that scheduling was easy. Only scheduling ease had a significant change during the pandemic, with 11% (2/11) of patients reporting difficulties with scheduling after starting telehealth ( P=0.03 ). Conclusion: Childhood stroke is a disease with significant morbidity and mortality, requiring close follow-up care. Families report robust preparedness for clinic after the implementation of a comprehensive discharge plan. Although small numbers, remote scheduling and telehealth transition may present previously unseen barriers to scheduling during the pandemic. During abrupt changes in clinical operations additional scheduling resources may be needed to ensure continuity of care.

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The Impact of Nongovernmental Organizations (NGOs) on Sustainable Development Projects in Katsina Metropolis

Journal of Economics Management and Trade ◽

10.9734/jemt/2019/v24i630183 ◽

2019 ◽

pp. 1-8

Author(s):

Naseer Babangida Muazu ◽

Abubakar Abdullahi

Keyword(s):

Sustainable Development ◽

Health Care Services ◽

Development Projects ◽

Skills Acquisition ◽

Chi Square ◽

Grass Root Level ◽

The Government ◽

Chi Square Analysis ◽

The Impact ◽

Structured Questionnaire

Nigeria is facing profound social, economic and environmental impact of population growth, development and environmental constraints. It is apparent that government alone has limited capacity to deal with all these problems. NGOs being one of the most effective partners have been playing supportive roles with the government, in some cases, they are considered more effective to get attached with the grass root level developmental initiatives. However, despite the role NGOs played, their presence and impact is not fully evaluated, recognized and appreciated by many governments and community members. It is for this reason this article attempts to examine whether projects executed by NGOs have any impact on sustainable development in Katsina Metropolis, given special emphasis on projects that dealt with environmental protection, poverty alleviation and health care services. The study further look at whether efficiency of NGOs officials has any impact on success of sustainable development projects execution. A structured questionnaire was used to collect data from 150 NGOs beneficiaries in five (5) selected political wards of twelve (12) in Katsina metropolis. Interviews was used to collect relevant data using a structured questionnaire from NGOs officials which include; development officers and facilitators in five (5) selected NGO offices operating in Katsina Metropolis namely; Save the Children, Service to Humanity Foundation, Murna Foundation, Katsina Friends of Environment and Makudawa Skills Acquisition. Frequency and chi-square analysis was used to present the results. The findings revealed that NGOs are complementing government efforts towards achieving sustainable development through their projects, and efficiency of NGOs officials has significant impact on success of sustainable development projects executed in the area. The findings of the study can benefit government and NGOs in creating more areas of collaboration in order to achieve sustainable development.

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Abstract P293: Disparate Outcomes for Stroke Patients With Documented Substance Use Compared to Those Without Substance Use

Stroke ◽

10.1161/str.52.suppl_1.p293 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Leslie Corless ◽

Tamela L Stuchiner ◽

Cameron Garvin ◽

Alexandra C Lesko ◽

Elizabeth Baraban

Keyword(s):

Substance Use ◽

Patient Characteristics ◽

Stroke Care ◽

Stroke Patients ◽

Chi Square ◽

Stroke Treatment ◽

Discharge Disposition ◽

Healthcare Settings ◽

Medical Histories ◽

The Impact

Background: Few studies have shown the impact of substance use (SU) on treatment and outcomes of stroke patients. Research suggests stigma related to SU impacts patient experience in healthcare settings. In this study we assessed whether there were differences in patient characteristics and outcomes for stroke patients with SU compared to those with no substance use (NSU). Methods: Retrospective data from two Oregon hospitals included patients admitted with stroke diagnosis, 18 years or older, who discharged between October 2017 and May 2019. Patients with documented SU and specific SU type were compared to patients with NSU with regard to demographics, medical history, stroke subtypes, treatment, discharge disposition and length of stay (LOS). SU was defined as any documented abuse of alcohol (ETOH), methamphetamine (MA), cannabis, opiates, cocaine, benzodiazepines, and Methyl-enedioxy-methamphetamine (MDMA). Non parametric median tests and Pearson’s chi square tests were used. Results: Among 2,030 patients included in the analysis, 13.8% (n=280) were SU and 86.2% (n=1,750) were NSU. Patients with SU were significantly younger, median age (61 vs. 73, p <.001) and less were female (35.4% vs. 53.6%, p <0.001). Those with SU had lower prevalence of dyslipidemia (43.6% vs. 59.5%, p <0.001), AFIB (12.5% vs. 22.2%, p <0.001), and previous TIA (6.1% vs 10.8%, p=0.02), and more smoked (54.3% vs 13.3% p <0.001). More patients with SU arrived via transfer (38.4% vs 27.4%, p=.001). Fewer patients with SU expired or were discharged to hospice (8.9% vs 13.7%) and a greater percent left against medical advice (AMA) (3.2% vs 0.6%) (p<.001). When comparing specific SU types to NSU, all SU groups were younger, had similar medical histories and a greater proportion left AMA. Only MA users had differentiating stroke diagnoses with a higher percent of SAH (14.5% vs 5.6%) (p=.003) in addition to longer LOS (6 vs 4 days, p=.006). No differences were found in acute stroke treatment rates. Conclusion: Patients with SU were demographically different from the NSU population and did differentiate on some stroke care outcomes and processes, potentially indicating opportunities to address stigma around substance use to meet the needs of patients with both stroke and substance use.

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Femoral head to lower lumbar neural foramen distance as a novel radiographic parameter to predict postoperative stretch neuropraxia

Journal of Neurosurgery Spine ◽

10.3171/2021.1.spine201989 ◽

2021 ◽

pp. 1-9

Author(s):

Alex S. Ha ◽

Meghan Cerpa ◽

Justin Mathew ◽

Paul Park ◽

Joseph M. Lombardi ◽

...

Keyword(s):

Logistic Regression ◽

Adult Spinal Deformity ◽

The Novel ◽

Continuous Variables ◽

Curve Correction ◽

Neural Foramen ◽

Chi Square ◽

Chi Square Analysis ◽

Lower Lumbar ◽

The Relationship

OBJECTIVE Lumbosacral fractional curves in adult spinal deformity (ASD) patients often have sharp coronal curves resulting in significant pain and imbalance. Postoperative stretch neuropraxia after fractional curve correction can lead to discomfort and unsatisfactory outcomes. The goal of this study was to use radiographic measures to increase understanding of the relationship between postoperative stretch neuropraxia and fractional curve correction. METHODS In 62 ASD patients treated from 2015 to 2018, radiographic review was performed, including measurement of the distance between the lower lumbar neural foramen (L4 and L5) in the concavity and convexity of the lumbosacral fractional curve and the ipsilateral femoral heads (FHs; L4–FH and L5–FH) in pre- and postoperative anteroposterior spine radiographs. The largest absolute preoperative to postoperative change in distance between the lower lumbar neural foramen and the ipsilateral FH (ΔL4/L5–FH) was used for analysis. Chi-square analyses, independent and paired t-tests, and logistic regression were performed to study the relationship between L4/L5–FH and stretch neuropraxia for categorical and continuous variables, respectively. RESULTS Of the 62 patients, 13 (21.0%) had postoperative stretch neuropraxia. Patients without postoperative stretch neuropraxia had an average ΔL4–FH distance of 16.2 mm compared to patients with stretch neuropraxia, who had an average ΔL4–FH distance of 31.5 mm (p < 0.01). Patients without postoperative neuropraxia had an average ΔL5–FH distance of 11.1 mm compared to those with stretch neuropraxia, who had an average ΔL5–FH distance of 23.0 mm (p < 0.01). Chi-square analysis showed that patients had a 4.78-fold risk of developing stretch neuropraxia with ΔL4–FH > 20 mm (95% CI 1.3–17.3) and a 5.17-fold risk of developing stretch neuropraxia with ΔL5–FH > 15 mm (95% CI 1.4–18.7). Logistic regression analysis indicated that the odds of developing stretch neuropraxia were 15:1 with a ΔL4–FH > 20 mm (95% CI 3–78) and 21:1 with a ΔL5–FH > 15 mm (95% CI 4–113). CONCLUSIONS The novel ΔL4/L5–FH distances are strongly associated with postoperative stretch neuropraxia in ASD patients. A ΔL4–FH > 20 mm and ΔL5–FH > 15 mm significantly increase the odds for patients to develop postoperative stretch neuropraxia.

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Abstract 239: 911 Caller Description of Seizure-Like Symptoms and Delays to Starting Telecommunicator CPR

Circulation ◽

10.1161/circ.140.suppl_2.239 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Author(s):

Kara Kronemeyer ◽

Kameron Shee ◽

Vatsal Chikani ◽

Normandy Villa ◽

Lesley Osborn ◽

...

Keyword(s):

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Process Measures ◽

Younger Patients ◽

Improve Accuracy ◽

Bystander Cardiopulmonary Resuscitation ◽

Data Points ◽

Chi Square Analysis ◽

Hospital Cardiac Arrest

Background: Bystander cardiopulmonary resuscitation (BCPR) improves survival after out-of-hospital cardiac arrest (OHCA). Identifying delays to starting Telecommunicator CPR (TCPR) may improve outcomes. Identifying terms callers use to describe seizure-like symptoms may improve accuracy and expedite TCPR. Methods: A total of 586 confirmed OHCA calls from 3 regional 911 centers in Arizona were reviewed between 2013 to 2016. Frequency of terms callers use to describe seizure-like symptoms were assessed. Demographics and TCPR process measures were compared between the seizure and non-seizure cohorts using Chi-square analysis for categorical variables and Kruskal-Wallis test for continuous variables. Other data points were time to start of seizure description, time to end of description, and time to start of seizure intervention. Results: There were 545 calls after exclusions. Twenty-six (.05%) had seizure-like symptoms described. Of these, “seizure” or “seizing” were used in 22 (84.6%) calls, “shaking” in 6 (23.1%), “cramping up” in 2 (7.7%) and convulsing in 2 (7.7%). Descriptions were more common in witnessed arrests [65.4% (17/26) vs. 34.6% (9/26); p=0.045] and in younger patients [median age=57 (QI=45, Q3=68) vs. 66 (Q1=51, Q3=77); p=0.036.] In calls with descriptions, telecommunicators were less likely to recognize OHCA [56.0% (14/25) vs. 74.5% (382/513), .031% (17/545) missing; (p=0.041] but bystanders were not less likely to start compressions [42.3% (11/26) vs. 57.6% (289/501), .033% (18/545) missing; p=0.122]. Median time to recognition in calls with descriptions was delayed vs. calls without descriptions [142 s (Q1=74 s, Q3=194 s), n=13, vs. 63 s (Q1=40 s, Q3=112 s), n=336; p=0.005], as was time to first chest compression [262 s (Q1=182 s, Q3=291 s), n=6 vs. 154 s (Q1=110 s, Q3=206 s), n=155; p=0.011]. Median times to start of description, end of description, and start of intervention were respectively: 33 s (Q1=20 s, Q3=40 s; 54 s (Q1=37 s, Q3=138 s; and 50 s (Q1=38 s, Q3=162 s). Conclusion: Description of seizure-like symptoms were uncommon and were associated with reduced and delayed OHCA recognition and delayed start of compressions.

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