Hospital patients with stroke symptoms require rapid expert evaluation and treatment to stop the brain damage, which can mean the difference between life and death. However, many hospitals do not have a round-the-clock stroke care team. To make up for this shortcoming, many American hospitals provide telemedicine consultations to stroke experts who may be located hundreds of miles away.
Researchers and colleagues at the Blavatnik School of Harvard Medical School.
This study was published online on March 1 in “JAMA Neurology” and represents the first national analysis of the prognosis of stroke patients. The results showed that compared with patients who attended similar hospitals that did not have stroke services, people who visited hospitals that provided telemedicine to assess stroke received better care and were more likely to survive the stroke.
The remote stroke service evaluated in this study enables hospitals without local expertise to connect patients with neurologists who specialize in stroke treatment. Using video, remote experts can virtually examine individuals with stroke symptoms, check radiological examinations, and advise on the best treatment options.
The use of remote stroke assessment is becoming more and more common. Telestroke is now used in almost one-third of US hospitals, but evaluation of its impact in many hospitals is still limited.
The senior author of the study, an associate professor of health care policy and medicine at HMS, and a resident at Beth Israel Deaconess Medical Center said: “Our findings provide important evidence that stroke can improve care and save lives.”
In this study, researchers compared the outcomes and 30-day survival rates of 150,000 stroke patients treated in more than 1,200 hospitals in the United States. Half of them provided stroke counseling, while the other half did not.
One of the results of the study is whether the patient has received reperfusion therapy, which can restore blood flow to the brain area affected by the stroke before irreparable damage occurs.
Compared with patients treated in non-Bihua hospitals, the relative rate of reperfusion therapy for patients treated in Bihua hospitals was 13% higher, and the relative rate of 30-day mortality was 4% lower. Researchers have found that hospitals with the fewest number of patients and hospitals in rural areas have the greatest positive benefits.
The lead author, Andrew Wilcock, assistant professor at the University of Vermont’s Lana School of Medicine, said: “In small rural hospitals, the use of stroke seems to be the biggest benefit-facilities that are rarely capable of stroke. “HMS Healthcare Policy Researcher. “These findings emphasize the need to address the financial barriers these smaller hospitals face in introducing strokes.”
Co-authors include Jessica Richard from HMS; Lee Schwamm and Kori Zachrison from HMS and Massachusetts General Hospital; Jose Zubizarreta from HMS, Harvard University’s Chenhe School of Public Health and Harvard University; and Lori-Uscher-Pines from RAND Corp.
This research was supported by the National Institute of Neurological Diseases and Stroke (Grant No. R01NS111952). DOI: 10.1001 / jamaneurol.2021.0023
Post time: Mar-03-2021