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Publication Date
2-2019
Disciplines
Neurology
Abstract
Introduction: Telestroke technology allows evaluation of stroke patients remotely. We sought to determine if there was any change in the standard of care and evaluation of stroke patients over time and whether there were differences in complication rates between those who were evaluated using telestroke technology and those who were not.
Methods: Data from April 2010 to May 2018 from a large stroke network were used. Acute ischemic stroke patients who presented to the emergency departments (ED) with last-known-well-to-door less than 4.5 hours and were treated with IV-alteplase were included. The number of facilities ranged from 7 in 2010 to 18 in 2017. Primary outcomes included the number and percentage of cases that were treated using telepresence (Beam-In) versus conventional care (no Beam-In) over time, as well as their discharge status and complications. Chi-squared or Linear By Linear Association were used to compare categorical variables and Mann-Whitney U Tests were used to compare continuous variables.
Results: A total of 1,150 patients were treated from 2010 to 2018, 75.8 % (n=872) via Beam-In. The number of Beam-Ins increased overtime and there was a significant increased trend in the percentage of treated Beam-Ins (p<.001) (graph). There were fewer patients discharged home (38.0% vs 50.4%, p<.001), more transferred to acute care facilities (37.6% vs 13.8%, p<.001) and fewer hospice or deaths (5.9% vs 12.9%, p<.001) for those treated via Beam-In. There was no significant difference in number of symptomatic intracranial hemorrhage, life threatening systemic hemorrhage or other serious complications.
Conclusion: Stroke care has evolved from traditional bedside care to more video evaluations in patients who received alteplase without increase in complications.
Area of Special Interest
Neurosciences (Brain & Spine)
Specialty/Research Institute
Neurosciences
Conference / Event Name
International Stroke Conference
Location
Honolulu, HI, United States
