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The impact of teleneurologists on acute stroke care at an advanced primary stroke centre
- Source :
- Journal of Telemedicine and Telecare. 28:115-121
- Publication Year :
- 2020
- Publisher :
- SAGE Publications, 2020.
-
Abstract
- Introduction We evaluated the impact of teleneurologists on the time to initiating acute stroke care versus traditional bedside neurologists at an advanced stroke center. Methods This observational study evaluated time to treatment for acute stroke patients at a single hospital, certified as an advanced primary stroke centre, with thrombectomy capabilities. Consecutive stroke alert patients between 1 March, 2016 and 31 March, 2018 were divided into two groups based on their neurology consultation service (bedside neurology: 1 March, 2016–28 February, 2017; teleneurology: 1 April, 2017–31 March, 2018). Door-to-tPA time and door-to-IR time for mechanical thrombectomy were compared between the two groups. Results Nine hundred and fifty-nine stroke patients met the inclusion criteria (436 bedside neurology, 523 teleneurology patients). There were no significant differences in sex, age, or stroke final diagnosis between groups ( p > 0.05). 85 bedside neurology patients received tPA and 35 had mechanical thrombectomy, 84 and 44 for the teleneurology group respectively. Door-to-tPA time (median (IQR)) was significantly higher among teleneurology (64 min (51.5–83.5)) than bedside neurology patients (45 min (34–69); p Discussion At this facility, our teleneurology services vendor was associated with a statistically significant delay in tPA administration compared with bedside neurologists. There was no difference in door-to-IR times. Delays in tPA administration make it harder to meet acute stroke care guidelines and could worsen patient outcomes.
- Subjects :
- medicine.medical_specialty
Telemedicine
business.industry
Health Informatics
Telehealth
medicine.disease
Stroke
03 medical and health sciences
0302 clinical medicine
Neurology
Emergency medicine
medicine
Humans
Observational study
Neurologists
030212 general & internal medicine
business
Referral and Consultation
030217 neurology & neurosurgery
Acute stroke
Subjects
Details
- ISSN :
- 17581109 and 1357633X
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Telemedicine and Telecare
- Accession number :
- edsair.doi.dedup.....3413697aeb701f6ba1f4a4ee838fcae8