Abstract
Introduction: our objective was to evaluate the efficacy of a Telestroke system, in terms of an increase in the number of patients treated with intravenous (IV) thrombolysis and a shorter door-to-needle time, in the metropolitan area of Madrid, Spain. Methods: prospective observational cohort study: 1) cohort exposed to Telestroke: acute ischemic stroke patients attended at Infanta Sofia University Hospital (community hospital) connected by Telestroke with the Stroke Center at La Paz University Hospital; 2) Non-exposed cohort: acute stroke patients who are attended at Severo Ochoa University Hospital (community hospital) connected by phone with the Stroke Center at Ramon y Cajal University Hospital. The number of patient attended, number of IV thrombolysis, times used (min), and the number of unnecessary transfers were recorded. We analyzed the first two years of the Telestroke (March 2010-March 2013). Results: in the Telestroke cohort the system was activated in 44 patients, being stroke code in 30 cases. In the non-exposed cohort 29 phone calls were made, being stroke code in 27 cases. In the Telestroke cohort, IV thrombolysis were administrated in 66.43% (19/30) of patients whereas in the non-exposed only 37% (10/27) received this treatment (p = 0,047). The door-to-needle time was shorter in Telestroke cohort than in the non-exposed cohort (mean (SD), 76.9 (33.3) vs. 132.7 (62.5), p = 0,022). In addition, there were fewer unnecessary secondary transfers in the Telestroke cohort (4% vs. 22.2%, P NS). Conclusion: the implementation of a Telestroke system in a metropolitan area is effective, increasing the number of IV thrombolysis and reducing the door-to-needle times.
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