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• W2897576486 abstract "Introduction: Telestroke is a practical tool to increasing stroke care delivery. Our aim was to investigate whether patients treated with intravenous tissue plasminogen activator (IV tPA) at the spoke sites were treated similarly to the hub. Methods: From 7/2015 to 5/2017, 662 consecutive patients were evaluated via telestroke by academic neurologists or vascular neurosurgeons from a comprehensive stroke program for consideration of acute therapeutic interventions. Of 162 patients for whom IV tPA was recommended, 156 were included in our analysis, excluding those who were in-house stroke activations and one pediatric patient. Data was collected from the telestroke database; further information on patients transferred to the hub site was collected from our local Get With The Guidelines-Stroke registry. Two-tailed t-tests were performed to compare the telestroke and direct-to-hub cohorts. Good outcome was defined as discharge to home, an inpatient rehabilitation facility, or AMA. Results: Among 655 telestroke activations, 162 received IV tPA, and among 860 direct-to-hub stroke activations, 216 received IV tPA, (24.7% vs 25.1%; p=0.17). Final diagnosis of acute ischemic stroke among treated patients is similar in the transferred telestroke and direct-to-hub cohorts (70.9% vs 63.0%, p=0.27). Of those who received tPA via telestroke, 55 were transferred to the hub site. Forty transfer patients (72.7%) came from a spoke site without access to neurology care. Transfer patients from spoke sites without neurology care had a median NIHSS of 8 vs 15.5 at spoke hospitals with access to neurology care. Direct-to-hub patients showed increased rates of good outcomes as compared to telestroke transfer patients (90.2% vs 74.5%, p=0.002). Conclusion: IV tPA treatment rates are similar among the telestroke and direct-to-hub cohorts. Telestroke patients transferred to the hub site and direct-to-hub patients have comparable rates of acute ischemic stroke diagnoses on discharge; however, direct-to-hub patients have greater rates of good outcomes at discharge. While both groups had high rates of good discharge dispositions, further analyses of differences between the groups are needed to evaluate differences in discharge disposition." @default.
• W2897576486 created "2018-10-26" @default.
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• W2897576486 date "2018-01-22" @default.
• W2897576486 modified "2023-09-27" @default.
• W2897576486 title "Abstract TP232: Telestroke and Direct-to-Hub tPA Treatment Rates are Similar at Academic Comprehensive Stroke Program" @default.
• W2897576486 doi "https://doi.org/10.1161/str.49.suppl_1.tp232" @default.
• W2897576486 hasPublicationYear "2018" @default.
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