Intravenous thrombolytic therapy for ischemic stroke via telemedicine compared with bedside treatment in an experienced stroke unit

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• 作者：L. Raulot^a ; G. Mione^b ; C.P. Hoffmann^b ; S. Bracard^c ; M. Braun^c ; ^d ; A. Brunner^e ; A. Vezain^f ; S. Langard^f ; F. Lesage^e ; L. Durupt^g ; S. Richard^a ; ^b ; ^{s.richard@chu-nancy.fr" class="auth_mail" title="E-mail the corresponding author} ; On behalf of the &ldquo ; VIRTUALL group&rdquo ; ¹
• 关键词：Telemedicine ; Telestroke ; Ischemic stroke ; Thrombolysis ; Recombinant tissue plasminogen activator ; Stroke unit
• 刊名：European Research in Telemedicine / La Recherche Européenne en Télémédecine
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：4
• 期：4
• 页码：119-125
• 全文大小：548 K

文摘

Telemedicine is emerging as a reliable tool for examining and delivering treatment to patients during the acute phase of stroke but little is known about patient outcome in this setting.

Methods

We compared time to examination and outcomes between two groups of consecutive patients treated with intravenous of recombinant tissue plasminogen activator (rt-PA) at the acute phase of ischemic stroke between 1st July 2013 and 30th June 2014. One group of patients was managed via a telestroke system (Virtuall, established in Lorraine, east France) and the second at the bedside in the stroke unit of Nancy Hospital.

Results

During this period, 27 patients received rt-PA via the telestroke system and 70 in the stroke unit. Both groups presented similar mean age and severity of stroke. There was no significant difference in median onset to needle times (180 minutes vs 170 minutes, P = 0.35), despite a longer door to needle time in the telestroke system group (86 minutes vs 55 minutes, P < 0.001). Outcome was similar in both groups: intracranial haemorrhage (19% vs 24%, P = 0.60); death (30% vs 20%, P = 0.42); and patient independence at 3 months (modified Rankin Scale score ≤ 1: 30% vs 31%, P = 1.00).

Conclusions

This study demonstrates that the telestroke system, Virtuall, is as safe and effective in initiating rt-PA treatment as bedside evaluation in an experienced stroke unit, despite a longer intra-hospital time.