Sujan Reddy1, Tzu-Ching Wu2, Jing Zhang3, Mohammad Hossein Rahbar4, Christy Ankrom5, Alicia Zha6, T C Cossey7, Benjamin Aertker8, Farhaan Vahidy9, Kaushik Parsha10, Erica Jones11, Anjail Sharrief12, Sean I Savitz13, Amanda Jagolino-Cole14. 1. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Sujan.T.Reddy@uth.tmc.edu. 2. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Tzu-Ching.Wu@uth.tmc.edu. 3. Department of Internal Medicine, The University of Texas Health Science Center, Houston, United States; Department of Biostatistics and Data Science, The University of Texas Health Science Center (UTHealth), Houston, United States. Electronic address: Jing.Zhang.1@uth.tmc.edu. 4. Department of Biostatistics and Data Science, The University of Texas Health Science Center (UTHealth), Houston, United States. Electronic address: Mohammad.H.Rahbar@uth.tmc.edu. 5. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Christy.Ankrom@uth.tmc.edu. 6. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Alicia.M.Zha@uth.tmc.edu. 7. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Tiffany.D.Cossey@uth.tmc.edu. 8. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Benjamin.M.Aertker@uth.tmc.edu. 9. Center for Outcomes Research, Houston Methodist, United States. Electronic address: FVahidy@houstonmethodist.org. 10. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Kaushik.N.Parsha@uth.tmc.edu. 11. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Erica.M.Jones@uth.tmc.edu. 12. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Anjail.Z.Sharrief@uth.tmc.edu. 13. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Sean.I.Savitz@uth.tmc.edu. 14. Department of Neurology and Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center (UTHealth), 6431 Fannin Street, MSB 7.125, Houston, TX 77030, United States. Electronic address: Amanda.L.Jagolino@uth.tmc.edu.
Abstract
INTRODUCTION: Differences in access to stroke care and compliance with standard of care stroke management among patients of varying racial and ethnic backgrounds and sex are well-characterized. However, little is known on the impact of telestroke in addressing disparities in acute ischemic stroke care. METHODS: We conducted a retrospective review of acute ischemic stroke patients evaluated over our 17-hospital telestroke network in Texas from 2015-2018. Patients were described as Non-Hispanic White (NHW) male or female, Non-Hispanic Black (NHB) male or female, or Hispanic (HIS) male or female. We compared frequency of tPA and mechanical thrombectomy (MT) utilization, door-to-consultation times, door-to-tPA times, and time-to-transfer for patients who went on to MT evaluation at the hub after having been screened for suspected large vessel occlusion at the spoke. RESULTS: Among 3873 patients (including 1146 NHW male (30%) and 1134 NHW female (29%), 405 NHB male (10%) and 491 NHB female (13%), and 358 HIS male (9%) and 339 HIS female (9%) patients), we did not find any differences in door-to consultation time, door-to-tPA time, time-to-transfer, frequency of tPA administration, or incidence of MT utilization. CONCLUSION: We did not find racial, ethnic, and sex disparities in ischemic stroke care metrics within our telestroke network. In order to fully understand how telestroke alleviates disparities in stroke care, collaboration among networks is needed to formulate a multicenter telestroke database similar to the Get-With-The Guidelines.
INTRODUCTION: Differences in access to stroke care and compliance with standard of care stroke management among patients of varying racial and ethnic backgrounds and sex are well-characterized. However, little is known on the impact of telestroke in addressing disparities in acute ischemic stroke care. METHODS: We conducted a retrospective review of acute ischemic strokepatients evaluated over our 17-hospital telestroke network in Texas from 2015-2018. Patients were described as Non-Hispanic White (NHW) male or female, Non-Hispanic Black (NHB) male or female, or Hispanic (HIS) male or female. We compared frequency of tPA and mechanical thrombectomy (MT) utilization, door-to-consultation times, door-to-tPA times, and time-to-transfer for patients who went on to MT evaluation at the hub after having been screened for suspected large vessel occlusion at the spoke. RESULTS: Among 3873 patients (including 1146 NHW male (30%) and 1134 NHW female (29%), 405 NHB male (10%) and 491 NHB female (13%), and 358 HIS male (9%) and 339 HIS female (9%) patients), we did not find any differences in door-to consultation time, door-to-tPA time, time-to-transfer, frequency of tPA administration, or incidence of MT utilization. CONCLUSION: We did not find racial, ethnic, and sex disparities in ischemic stroke care metrics within our telestroke network. In order to fully understand how telestroke alleviates disparities in stroke care, collaboration among networks is needed to formulate a multicenter telestroke database similar to the Get-With-The Guidelines.
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