Audebert, Heinrich J. and Kukla, Christian and Vatankhah, Bijan and Gotzler, Berthold and Schenkel, Johannes and Hofer, Stephan and Fuerst, Andrea and Haberl, Roman L. (2006) Comparison of tissue plasminogen activator administration management between telestroke network hospitals and academic stroke centers - The Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany. STROKE, 37 (7). pp. 1822-1827. ISSN 0039-2499,
Full text not available from this repository. (Request a copy)Abstract
Background and Purpose-Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. Methods-During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. Results-In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and I 10 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P = 0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Conclusions-Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE ISCHEMIC-STROKE; COOPERATIVE ACUTE STROKE; THROMBOLYTIC THERAPY; T-PA; INTRAVENOUS THROMBOLYSIS; CLINICAL-PRACTICE; EXPERIENCE; ECASS; MORTALITY; ALTEPLASE; stroke; telemedicine; thrombolysis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 11 Feb 2021 10:40 |
| Last Modified: | 11 Feb 2021 10:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/34418 |
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