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- Title
Enhancement of Intravenous Thrombolysis by Nationwide Telestroke Care in Slovenia: A Model of Care for Middle-Income Countries.
- Authors
Zupan, Matija; Zaletel, Marjan; Žvan, Bojana
- Abstract
Background:Stroke expertise is critical for timely and appropriate intravenous thrombolysis (IVT) and affects IVT use. Introduction:In Slovenia, IVT is administered in general hospitals, which often lack on-site neurologic expertise. To overcome this obstacle, a national telestroke network, TeleKap, has been implemented. The aim of the study was to determine whether TeleKap is associated with enhanced IVT use. Materials and Methods:This investigation was a retrospective observational study comparing the number of acute ischemic stroke (AIS) patients and the use of IVT during the first 3 consecutive years. TeleKap, a decentralized hub-and-spoke telestroke model covering the entire nation, consists of one comprehensive stroke center and 12 spokes classified according to the availability of on-site neurologic expertise. Results:During the observation period, we treated a total of 1,316 patients with AIS, of which 508 (38.6%) received IVT. We found statistically significant positive trends in the number of IVT patients (142 in 2015, 158 in 2016, and 208 in 2017; B = 4.39, standard error (SE) = 1.59, p = 0.01) and the number of AIS patients (326 in 2015, 424 in 2016, and 566 in 2017; B = 14.42, SE = 5.19, p = 0.01) for all spokes. The trend in the IVT rate was numerically negative but did not reach statistical significance (43.5% in 2015, 37.3% in 2016, and 36.7% in 2017; p = 0.30). Discussion:TeleKap enhanced IVT use regardless of on-site neurologic expertise. Conclusions:TeleKap proved to be efficient. It could serve as a model of telestroke care for other similar countries.
- Subjects
SLOVENIA; THROMBOLYTIC therapy; MIDDLE-income countries; HIGH-income countries; STATISTICAL significance; NUMBER theory; HOSPITAL care; STROKE
- Publication
Telemedicine & e-Health, 2020, Vol 26, Issue 4, p462
- ISSN
1530-5627
- Publication type
Article
- DOI
10.1089/tmj.2019.0046