Abstract WP251: Telestroke 2.0 in Catalonia More Patients Treated and Secondary Transfers Reduced


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Abstract

Objetive: To describe the main results from the implementation of Telestroke 2.0 in Catalonia.Methods: The network consists of 12 community hospitals and an expert stroke neurologist 24h/7d, covering a population of 1.3 million inhabitants. It includes a two-way videoconferencing system and visualization of neuroimaging on a web platform. The neurologist evaluates the patient and decides the therapeutic approach and/or transfer the patient to another facility, entering these data in a mandatory registry (TICAT). Simultaneously, all patients treated locally with reperfusion therapies in all centers of Catalonia are also prospectively recorded in a mandatory registry (SONIIA).Results: From March-2013 to December-2015, 1206 patients were evaluated through Telestroke network. Final diagnosis was: 951 ischemic, 51 TIA, 85 intracranial hemorrhages and 119 with a diagnosis different from stroke. Transfer to another center was avoided in 46.8% of ischemic, 76.5% of TIAs and 23.5% of hemorrhages. A total of 322 patients received rtPA (33.8% of ischemic). Compared with those who received rtPA locally (2897 patients in the same period in Catalonia), the door-to-needle time(minutes) was longer in treated through Telestroke (55[45-70] versus 44[32-59]), and this time was progressively reduced from 2013 to 2015 (59[53- 82] to 40[50-60], p<0.001). Baseline and 24h NIHSS, rate of symptomatic hemorrhage, mRS at 3m and percentage of patients receiving rescue thrombectomy were similar in both groups. Population rate of fibrinolysis /100.000 inhabitants in Catalonia increased progressively from 2012 to 2015.Conclusions: Telestroke favors fibrinolysis therapy safely and effectively, avoiding a large number of secondary transfers to other centers

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