October 4, 2013 — A telestroke service increases the rate of effective tissue plasminogen activator (tPA) therapy for patients with acute ischemic stroke treated at community hospitals, according to a report in the October issue of Neurosurgery.
Stavropoula Tjoumakaris, M.D., and colleagues of Thomas Jefferson University Hospital evaluated the effects of a telestroke network that included 28 community hospitals in the Philadelphia area. In the network, stroke specialists used "remote presence" technology to consult on the care of stroke patients seen at hospitals that did not have a specialized stroke unit. The study evaluated the rate of appropriate treatment with tPA.
Over 18 months, the service provided nearly 1,650 remote stroke consultations. The average time from request to telemedicine response was 12 minutes. About 14 percent of patients received tPA, including nearly all of those who could be treated in the appropriate time window. By comparison, national data suggest that only 3 to 5 percent of patients with ischemic stroke receive tPA.
About 80 percent of network hospitals increased their use of tPA for acute ischemic stroke. The percentage of patients transferred to a specialized stroke center decreased as well, possibly because patients began to improve at their original hospital.
“The results support the implementation of telestroke networks for wider access to stroke expertise in underserved regions," concluded researchers
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