Effects of Telestroke on Thrombolysis Times and Outcomes: A Meta-analysis

Baratloo, Alireza; Rahimpour, Leila; Abushouk, Abdelrahman Ibrahim; Safari, Saeed; Lee, Chung Wing; Abdalvand, Ali

doi:10.1080/10903127.2017.1408728

Cited by 71 publications

(79 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar findings have been reported in the US and Canada . In a meta‐analysis of 26 studies (6605 patients receiving thrombolysis), no significant differences were found between stroke telemedicine and control groups in terms of in‐hospital mortality, 90‐day mortality, symptomatic intracranial haemorrhage, and clinical outcome at discharge or at 90‐day follow‐up …”

Section: Discussionsupporting

confidence: 83%

Improving acute stroke care in regional hospitals: clinical evaluation of the Victorian Stroke Telemedicine program

Bladin

Kim

Bagot

et al. 2020

Medical Journal of Australia

View full text Add to dashboard Cite

Objectives:To evaluate the impact of the Victorian Stroke Telemedicine (VST) program during its first 12 months on the quality of care provided to patients presenting with suspected stroke to hospitals in regional Victoria.Design: Historical controlled cohort study comparing outcomes during a 12-month control period with those for the initial 12 months of full implementation of the VST program at each hospital.Participants: Adult patients with suspected stroke presenting to the emergency departments of the participating hospitals. Main outcome measures:Indicators for key processes of care, including symptom onset-to-arrival, door-to-first medical review, and door-to-CT times; provision and timeliness of provision of thrombolysis to patients with ischaemic stroke.Results: 2887 patients with suspected stroke presented to participating emergency departments during the control period, 3178 during the intervention period; the patient characteristics were similar for both periods. A slightly larger proportion of patients with ischaemic stroke who arrived within 4.5 hours of symptom onset received thrombolysis during the intervention than during the control period (37% v 30%). Door-to-C T scan time (median, 25 min [IQR, 13-49 min] v 34 min [IQR, 18-76 min]) and door-to-needle time for stroke thrombolysis (73 min [IQR, 56-96 min] v 102 min [IQR, 77-128 min]) were shorter during the intervention. The proportions of patients who received thrombolysis and had a symptomatic intracerebral haemorrhage (4% v 16%) or died in hospital (6% v 20%) were smaller during the intervention period.Conclusions: Telemedicine has provided Victorian regional hospitals access to expert care for emergency department patients with suspected acute stroke. Eligible patients with ischaemic stroke are now receiving stroke thrombolysis more quickly and safely.The known: Telemedicine support has improved access to acute stroke therapies in regional hospitals overseas, but has not been provided on a large scale in Australia.The new: The Victorian Stroke Telemedicine (VST) program in 16 hospitals in regional Victoria was associated with improved delivery of acute stroke therapies, including providing thrombolysis more quickly and safely. The implications:The VST program has improved access to stroke specialists in regional Victoria and the quality of care for people with acute stroke. The program is now fully funded by the Victorian government.

show abstract

Section: Discussionsupporting

confidence: 83%

Improving acute stroke care in regional hospitals: clinical evaluation of the Victorian Stroke Telemedicine program

Bladin

Kim

Bagot

et al. 2020

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…Therefore, hybrid models were developed to provide a partially outpatient and partially telemonitored, home-based CR programme [11]. This has been reinforced by the recent successes of telemedicine in several emergency and rehabilitation indications [27][28][29]. In this study, we aimed to provide class I evidence regarding the comparability of hybrid CR models to the standard CR programmes.…”

Section: Discussionmentioning

confidence: 99%

Hybrid versus traditional cardiac rehabilitation models: a systematic review and meta-analysis

Wu¹,

Chen³

2018

Kardiol Pol

View full text Add to dashboard Cite

show abstract

“…It has been reported that only 1-8% of stroke patients receive proper treatment and the others face poor outcomes due to delayed referral [3][4][5][6]. Therefore, prompt action is needed to identify patients with stroke as soon as possible, even in the pre-hospital stage [7]. Although public education at the community level plays an undeniable role in promptly calling emergency medical services (EMS) after a stroke, effective interventions in the healthcare system begin the moment a patient or his/her companion contacts EMS.…”

Section: Introductionmentioning

confidence: 99%

A multi-center diagnostic accuracy study on nine Prehospital Stroke Screening Scales

Saberian

Rafiemanesh

Heydari

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Stroke is one of the most common debilitating diseases. Although effective treatment is available, but a golden-time has been defined in this regard. Therefore, prompt action is needed to identify patients with stroke as soon as possible, even in the pre-hospital stage. In recent years, several clinical scales have been introduced for this purpose. We performed the present study to examine the accuracy of 9 clinical scales in terms of stroke diagnosis.Methods: This multi-center diagnostic accuracy study has been conducted during 2019. All patients older than 18 years, presenting to ED, who had undergone brain magnetic resonance imaging (MRI) due to suspicion of stroke were eligible. All data were gathered in a pre-designed checklist consisting of 3 sections, using the clinical profiles of the patients. The first section of the checklist included baseline characteristics and demographic data. The second part included physical examination findings of 19 items related to the 9 scales. The third part was dedicated to the final diagnosis based on the interpretation of brain magnetic resonance imaging (MRI), which was considered the gold standard method for acute ischemic stroke (AIS) diagnosis in the current study.Results: Data of 805 patients suspected to stroke were analyzed. Of all, 463 (57.5%) patients were male. Participants’ age was between 6 and 95 years and their mean age was 66.9 years (SD=13.9). Off all the enrolled patients, 562 patients (69.8%) had acute ischemic stroke. The accuracy of screening tests was between 63.0% and 84.4%. Their sensitivity and specificity were between 50.2% to 95.7% and 46.5% to 92.2%, respectively. Among all the screening tests, RACE had the lowest sensitivity (50.2%) and MedPACS had the highest (95.7%). In addition, PreHAST had the lowest specificity (46.5%) and RACE had the highest (92.2%).Conclusion: Based on the findings of the present study, highly sensitive tests that can be used in this regard are CPSS, FAST and MEDPACS, all of which have about 95% sensitivity. On the other hand, none of the studied tools were desirable (specificity above 95%) in any of the examined cut-offs.

show abstract

Effects of Telestroke on Thrombolysis Times and Outcomes: A Meta-analysis

Cited by 71 publications

References 43 publications

Improving acute stroke care in regional hospitals: clinical evaluation of the Victorian Stroke Telemedicine program

Improving acute stroke care in regional hospitals: clinical evaluation of the Victorian Stroke Telemedicine program

Hybrid versus traditional cardiac rehabilitation models: a systematic review and meta-analysis

A multi-center diagnostic accuracy study on nine Prehospital Stroke Screening Scales

Contact Info

Product

Resources

About