Telestroke Improves Care and Saves Lives in Ischemic Stroke Patients: JAMA study

Researchers identified patients with acute ischemic stroke who first presented to hospitals with telestroke capacity and matched them with patients who presented to control hospitals without telestroke capacity between January 2008 and June 2017. Matching was based on sociodemographic and clinical characteristics, hospital characteristics, and month and year of admission. In 643 hospitals with telestroke capacity, there were 76 636 patients with stroke who were matched 1:1 to patients at similar hospitals without telestroke capacity. The major outcomes assessed were 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.

Key findings of the study were:

• Upon analysis, researchers have found that the patients cared for at telestroke hospitals had higher rates of reperfusion treatment compared with those cared for at control hospitals (6.8% vs 6.0%; difference) and lower 30-day mortality (13.1% vs 13.6%; difference).

• They found no differences in days spent living in the community following discharge or in spending.

• They observed largest positive benefits at hospitals with the lowest patient volume, hospitals in rural areas and among patients 85 years and older.

The authors concluded, "we found that patients with stroke first cared for at a hospital with telestroke capacity were more likely to receive reperfusion treatment with alteplase or thrombectomy and have lower short-term mortality compared with those first cared for at a hospital without telestroke capacity."

For further information:

https://jamanetwork.com/journals/jamaneurology/fullarticle/2776793