NDLI: Telestroke in South Carolina.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lazaridis, Christos DeSantis, Stacia M. Jauch, Edward C. Adams, Robert J.
Spatial Coverage	South Carolina
Description	Author Affiliation: Lazaridis C ( Division of Vascular Neurology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina)
Abstract	BACKGROUND: The administration of thrombolysis to eligible patients is often limited to centers with expertise. This study was intended to report on the safety and efficacy (in increasing thrombolysis availability) of telemedicine in the acute assessment and treatment of stroke patients presenting to hospitals in distant locations from a designated stroke center. METHODS: A web-based telestroke tool (remote evaluation of acute ischemic stroke at Medical University of South Carolina [REACH-MUSC]), was implemented to provide acute stroke care 24 hours per day, 7 days per week to 12 community hospitals in South Carolina. RESULTS: Nine hundred sixty-five consults were performed. Among the 525 patients with a National Institutes of Health Stroke Score >3, 185 (35.7%) were treated with intravenous tissue plasminogen activator (t-PA) alone, 15 (2.9%) received combination of intravenous and intra-arterial thrombolysis/thrombectomy, and 11 (2.1%) were treated with intra-arterial therapy alone. Of those who received intravenous t-PA, 119 (64.3%) were transferred to the hub; the medians (interquartile range) for onset to treatment for the intravenous t-PA and the intravenous t-PA and intra-arterial groups were 152 (range 115-193) minutes and 147 (range 107-179) minutes, respectively. Three patients (1.6%) who received intravenous t-PA alone experienced symptomatic intracerebral hemorrhage. The most common reason for not receiving thrombolysis was patient presentation outside the time window for treatment. CONCLUSIONS: Telestroke can have a major impact in increasing thrombolysis rates in remote areas from specialized centers, and in particular in areas where t-PA is underutilized.
File Format	HTM / HTML
ISSN	10523057
Issue Number	7
Volume Number	22
e-ISSN	15328511
Journal	Journal of Stroke and Cerebrovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Research Support, Non-u.s. Gov't Brain Ischemia Stroke Humans Middle Aged Drug Therapy Male Treatment Outcome Aged, 80 And Over Fibrinolytic Agents Therapeutic Use South Carolina Journal Article Tissue Plasminogen Activator Telemedicine Time Factors Discipline Cardiology Thrombolytic Therapy Female Aged Diagnosis
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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