Telemed J E Health - Robotic telepresence versus standardly supervised stroke alert team assessments.

Tópicos

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Resumo

CKGROUND: Telemedicine has created access to emergency stroke care for patients in all communities, regardless of geography. We hypothesized that there is no difference in speed of assessment between vascular neurologist (VN) robotic telepresence and standard VN-supervised stroke alert patients in a metropolitan primary stroke center.MATERIALS AND METHODS: A retrospective stroke alert database was used to identify all robotic telepresence and standardly supervised stroke alert patient assessments at a primary stroke center emergency department from 2009 to 2012. The primary outcome measure was the duration of assessment from stroke alert activation to treatment or downgrade.RESULTS: The sample size was 196 subjects. The mean duration of time from stroke alert activation to initiation of intravenous (IV) thrombolytic treatment or downgrade was 8.6min longer in the robotic group than in the standard group (p=0.03). Among the subgroup of acute ischemic stroke patients treated with IV thrombolysis, the mean duration of time from activation to treatment was 18min longer in the robotic group than in the standard group (p=0.01). Safety outcomes including thrombolysis protocol violations (0% versus 1%), post-thrombolysis symptomatic intracranial hemorrhagic complications (3% versus 1%), and death during hospitalization (8% versus 6%) were low in the robotic group and not significantly different from that in the standard group.CONCLUSIONS: Standard VN-supervised acute stroke team assessments were swifter than those supervised by robotic telepresence. Safety outcomes of robotic telepresence-supervised stroke alerts were excellent, and this modality may be preferred in circumstances when a VN is not immediately available on-site.

Resumo Limpo

ckground telemedicin creat access emerg stroke care patient communiti regardless geographi hypothes differ speed assess vascular neurologist vn robot telepres standard vnsupervis stroke alert patient metropolitan primari stroke centermateri method retrospect stroke alert databas use identifi robot telepres standard supervis stroke alert patient assess primari stroke center emerg depart primari outcom measur durat assess stroke alert activ treatment downgraderesult sampl size subject mean durat time stroke alert activ initi intraven iv thrombolyt treatment downgrad min longer robot group standard group p among subgroup acut ischem stroke patient treat iv thrombolysi mean durat time activ treatment min longer robot group standard group p safeti outcom includ thrombolysi protocol violat versus postthrombolysi symptomat intracrani hemorrhag complic versus death hospit versus low robot group signific differ standard groupconclus standard vnsupervis acut stroke team assess swifter supervis robot telepres safeti outcom robot telepresencesupervis stroke alert excel modal may prefer circumst vn immedi avail onsit

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