Enhancement of Intravenous Thrombolysis by Nationwide Telestroke Care in Slovenia: A Model of Care for Middle-Income Countries.
Telemed J E Health
; 26(4): 462-467, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-31140945
ABSTRACT
Background:
Stroke expertise is critical for timely and appropriate intravenous thrombolysis (IVT) and affects IVT use.Introduction:
In Slovenia, IVT is administered in general hospitals, which often lack on-site neurologic expertise. To overcome this obstacle, a national telestroke network, TeleKap, has been implemented. The aim of the study was to determine whether TeleKap is associated with enhanced IVT use.Materials andMethods:
This investigation was a retrospective observational study comparing the number of acute ischemic stroke (AIS) patients and the use of IVT during the first 3 consecutive years. TeleKap, a decentralized hub-and-spoke telestroke model covering the entire nation, consists of one comprehensive stroke center and 12 spokes classified according to the availability of on-site neurologic expertise.Results:
During the observation period, we treated a total of 1,316 patients with AIS, of which 508 (38.6%) received IVT. We found statistically significant positive trends in the number of IVT patients (142 in 2015, 158 in 2016, and 208 in 2017; B = 4.39, standard error (SE) = 1.59, p = 0.01) and the number of AIS patients (326 in 2015, 424 in 2016, and 566 in 2017; B = 14.42, SE = 5.19, p = 0.01) for all spokes. The trend in the IVT rate was numerically negative but did not reach statistical significance (43.5% in 2015, 37.3% in 2016, and 36.7% in 2017; p = 0.30).Discussion:
TeleKap enhanced IVT use regardless of on-site neurologic expertise.Conclusions:
TeleKap proved to be efficient. It could serve as a model of telestroke care for other similar countries.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Isquemia Encefálica
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Telemedicina
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Accidente Cerebrovascular
Tipo de estudio:
Observational_studies
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Telemed J E Health
Asunto de la revista:
INFORMATICA MEDICA
/
SERVICOS DE SAUDE
Año:
2020
Tipo del documento:
Article
País de afiliación:
Eslovenia
Pais de publicación:
EEUU
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ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
/
EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
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USA