Dipankar Dutta1, Jason Kendall2, Clare Holmes2, Peter Murphy2, Toby Black2, Robert Whiting2, Kash Aujla2, Sarah Caine2, Kate Hellier2, David Walters2. 1. From the Stroke Department, Gloucestershire Royal Hospital, Gloucester, UK (D.D., K.H.); Emergency Department, Southmead Hospital, Bristol, UK (J.K.); Stroke Department, Bristol Royal Infirmary, Bristol, UK (C.H., P.M., S.C.); Stroke Department, Salisbury District Hospital, Salisbury, UK (T.B., D.W.); Stroke Department, Musgrove Park Hospital, Taunton, UK (R.W.); and Emergency Department, Great Western Hospital, Swindon, UK (K.A.). dipankar.dutta@glos.nhs.uk. 2. From the Stroke Department, Gloucestershire Royal Hospital, Gloucester, UK (D.D., K.H.); Emergency Department, Southmead Hospital, Bristol, UK (J.K.); Stroke Department, Bristol Royal Infirmary, Bristol, UK (C.H., P.M., S.C.); Stroke Department, Salisbury District Hospital, Salisbury, UK (T.B., D.W.); Stroke Department, Musgrove Park Hospital, Taunton, UK (R.W.); and Emergency Department, Great Western Hospital, Swindon, UK (K.A.).
Abstract
BACKGROUND AND PURPOSE: There is limited evidence for remote stroke thrombolysis using telephone consultation and teleradiology. Results from a UK network using this treatment model are presented. METHODS: Retrospective study of consecutive patients thrombolysed in 5 hospitals, with well organized stroke services, between 2012 and 2013. Remote thrombolysis was compared with thrombolysis delivered in person for symptomatic intracerebral hemorrhage, death within 7 days, and 90-day modified Rankin scores. RESULTS: Of 586 patients, 220 (37.5%) were thrombolysed remotely. The 2 groups were well matched (median age 77 years, NIHSS 12). Remote thrombolysis increased treatment time by 22 minutes. Outcomes were no different in the 2 groups (remote versus standard): symptomatic intracerebral hemorrhage (3.6% versus 4.6%), death within 7 days (6.4% versus 7.1%), modified Rankin score <2 (46.0% versus 46.1%), and modified Rankin score 6 (15% versus 17.5%) at 90 days. CONCLUSION: Telephone advice and teleradiology, within an organized system of care, can be an effective method of delivery of intravenous thrombolysis.
BACKGROUND AND PURPOSE: There is limited evidence for remote stroke thrombolysis using telephone consultation and teleradiology. Results from a UK network using this treatment model are presented. METHODS: Retrospective study of consecutive patients thrombolysed in 5 hospitals, with well organized stroke services, between 2012 and 2013. Remote thrombolysis was compared with thrombolysis delivered in person for symptomatic intracerebral hemorrhage, death within 7 days, and 90-day modified Rankin scores. RESULTS: Of 586 patients, 220 (37.5%) were thrombolysed remotely. The 2 groups were well matched (median age 77 years, NIHSS 12). Remote thrombolysis increased treatment time by 22 minutes. Outcomes were no different in the 2 groups (remote versus standard): symptomatic intracerebral hemorrhage (3.6% versus 4.6%), death within 7 days (6.4% versus 7.1%), modified Rankin score <2 (46.0% versus 46.1%), and modified Rankin score 6 (15% versus 17.5%) at 90 days. CONCLUSION: Telephone advice and teleradiology, within an organized system of care, can be an effective method of delivery of intravenous thrombolysis.
Authors: Morgan B Swanson; Aspen C Miller; Marcia M Ward; Fred Ullrich; Kimberly As Merchant; Nicholas M Mohr Journal: J Telemed Telecare Date: 2019-11-04 Impact factor: 6.344