Trends in Telestroke Care Delivery A 15-Year Experience of an Academic Hub and Its Network of Spokes
Trends in Telestroke Care Delivery A 15-Year Experience of an Academic Hub and Its Network of Spokes
复制标题
DOI：
10.1161/circoutcomes.119.005903
复制
发表时间：
2020-03-01
影响因子：
6.9
通讯作者：
Schwamm, Lee H.
中科院分区：
文献类型：
--
作者：
Sharma, Richa;Zachrison, Kori S.;Schwamm, Lee H.
背景：远程卒中为缺乏卒中覆盖的医院提供了获得血管神经学专业知识的途径，其使用在过去十年中迅速上升。我们的目标是在一个学术远程卒中网络中表征会诊、说话行为以及说话电话卒中利用率(每年的电话中风咨询次数)和讲话阿尔替普斯治疗指标之间的关系。方法和结果：我们分析了2003-2018年间所有电话中风咨询的前瞻性收集数据。使用通用估计方程和Kendall tau beta非参数检验分析了网络性能和辐条特性的趋势。未调整和调整的线性回归模型确定了远程卒中利用率和治疗指标之间的关联。该网络包括2个枢纽和43个辐条，在研究期间进行了12 803次会诊。总体网络增长为每年+1.8辐条，参与辐条的平均持续时间为7.9年。就诊和接受阿替普斯治疗的患者数量每年都在增加，即使在对网络中的辐条数量进行调整后也是如此(P
Background:Telestroke provides access to vascular neurology expertise for hospitals lacking stroke coverage, and its use has risen rapidly in the past decade. We aim to characterize consultations, spoke behavior, and the relationship between spoke telestroke utilization (number of telestroke consults per year) and spoke alteplase treatment metrics in an academic telestroke network.Methods and Results:We analyzed prospectively collected data on all telestroke consults from 2003 to 2018. Trends in network performance and spoke characteristics were analyzed using generalized estimating equations and Kendall tau beta nonparametric tests as appropriate. Unadjusted and adjusted linear regression models determined associations between telestroke utilization and treatment metrics. The network included 2 hubs and 43 spokes with 12 803 consults performed during the study period. Network growth overall was +1.8 spokes per year, and median duration of spoke participation was 7.9 years. The numbers of consults and alteplase-treated patients increased annually, even after adjusting for the number of spokes in the network (P