Abstract W P194: Telestroke is Not Associated With a Lower Rate of IV Thrombolysis
Background: Telestroke is an increasingly used mode of assessment of acute stroke patients when vascular neurologists are not available onsite. We provided onsite stroke hospitalist services at a local community hospital via onsite, bedside assessment for 18 months. Coverage was then transitioned to telestroke only assessment, at the same hospital with the same vascular neurologists. We sought to determine if IV r-tPA rates changed.
Methods: Onsite coverage was from April 2011 through September 2012 (Group 1). Telestroke only coverage was from October 2012 through July 2013 (Group 2). We reviewed all acute stroke codes and determined which patients were treated with IV r-tPA. We also collected door to needle (DTN) times. Fisher’s exact and independent t-tests were used where appropriate.
Results: In Group 1 there were 578 acute stroke codes. 52 of these patients (8.9%) received IV r-tPA. Group 2 had 356 acute stroke codes, 29 of which received IV r-tPA (8.1%). This difference was not statistically significant (p=0.7201). Mean number of patients treated with IV r-tPA per month was 2.8 for Group 1 and 2.9 for Group 2. Mean DTN time was 76.73 min for Group 1 and 90.63 min for Group 2. This shows a trend toward shorter DTN times with bedside assessment but this difference is not statistically significant (p=0.0798).
Conclusion: IV r-tPA administration rates do not fall when a telestroke only coverage model replaces an onsite model. This suggests that telestroke coverage is sufficient to maintain IV r-tPA treatment rates, even when vascular neurologists are not available at the bedside.
Author Disclosures: N. Shafi: None. S. Hoelzel: None. R. Grysiewicz: None. A. Khaja: None. F.D. Testai: None.
- © 2014 by American Heart Association, Inc.