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Reperfusion Treatment and Stroke Outcomes in Hospitals With Telestroke Capacity

By Currents Editor posted 04-23-2021 08:32

  

JAMA Neurology (03/01/21) DOI: 10.1001/jamaneurol.2021.0023

Wilcock, Andrew D.; Schwamm, Lee H.; Zubizarreta, Jose R.; et al.

https://jamanetwork.com/journals/jamaneurology/article-abstract/2776793 

Patients with ischemic stroke who received care at hospitals with telestroke services are more likely to receive reperfusion therapy, and their 30-day mortality rate is lower than that for patients treated at hospitals without telestroke capacity, according to a large study. The study, which include 153,272 patients treated for stroke, found that increases in reperfusion treatment were highest among smaller hospitals, among rural residents, and among individuals aged 85 years and older. Researchers identified 76,636 patients with stroke at 643 U.S. hospitals with telestroke services at matched them to an equal number of patients at similar hospitals with no telestroke capacities. In all, 57.7% of the patients were female, and the mean age was 78.8 years. Primary outcomes and measures included receipt of reperfusion treatment through thrombolysis with alteplase or thrombectomy, mortality at 30 days from admission, spending through 90 days from admission, and functional status as measured by days spent living in the community after discharge. The rate of reperfusion treatment at telestroke hospitals was 6.8%, compared with 6.0% at the control hospitals, while 30-day mortality rates were 13.1% and 13.6%, respectively. The researchers also noted there were no differences in days spent living in the community after discharge or in spending through 90 days from admission.

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