Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores

Background: Acute ischemic stroke (AIS) is one of the leading causes of death in Chile. Intravenous thrombolysis (IVT) is an effective treatment. Geographical barriers and lack of specialists limit its application. Telemedicine can overcome some of these pitfalls. Aim: To describe the implementati...

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Autores principales:	Mansilla,Eloy, Mazzon,Enrico, Cárcamo,Daniel, Jurado,Felipe, Lara,Lorena, Arévalo,Mirya, Rojas,Diego, Stephens,Gloria, Hoppe,Arnold, Brunser,Alejandro
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2019
Materias:	Fibrinolysis Thrombolytic Therapy Stroke Remote Consultation Telemedicine Chile
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000901107
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spelling	oai:scielo:S0034-988720190009011072020-01-07Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutoresMansilla,EloyMazzon,EnricoCárcamo,DanielJurado,FelipeLara,LorenaArévalo,MiryaRojas,DiegoStephens,GloriaHoppe,ArnoldBrunser,Alejandro Fibrinolysis Thrombolytic Therapy Stroke Remote Consultation Telemedicine Chile Background: Acute ischemic stroke (AIS) is one of the leading causes of death in Chile. Intravenous thrombolysis (IVT) is an effective treatment. Geographical barriers and lack of specialists limit its application. Telemedicine can overcome some of these pitfalls. Aim: To describe the implementation and results of AIS treatment by telemedicine at the TeleStroke Unit (TeleACV) of the Southern Metropolitan Health Service, connected with seven hospitals in Chile. Material and Methods: Descriptive analysis of a prospective tele-thrombolysis data-base that covers from 2016 to 2018, with an emphasis in the last year. Results: During the analyzed period, seven remote telemedicine centers were activated as far as 830 kilometers on a continental level from the reference center and up to 3,700 kilometers on an island level. There were 1,024 telemedicine consultations, 144 (14%) of them resulted in an IVT treatment. During 2018, 597 tele-consultations were made, thrombolysis was done in 115 (19%) patients aged 66+-13 years; 54 (46.6%) being female. The median admission National Institute of Health Stroke Scale was 8 (interquartile range (IQR) 5-14). The median door-to-needle time was 56.5 (IQR 44.8-73.3) minutes; 60% of patients were treated within 60 minutes. Eight patients (7%) were referred for a subsequent mechanical thrombectomy to a center of greater complexity. Symptomatic intra-cranial hemorrhages occurred in four treated patients (4%). One patient had a systemic bleeding. Conclusions: The Telestroke Unit achieved a high rate of IVT and good door-to-needle times. This may help to overcome some of the geographic barriers and the specialist availability gap in our country.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.147 n.9 20192019-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000901107es10.4067/s0034-98872019000901107
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Fibrinolysis Thrombolytic Therapy Stroke Remote Consultation Telemedicine Chile
spellingShingle	Fibrinolysis Thrombolytic Therapy Stroke Remote Consultation Telemedicine Chile Mansilla,Eloy Mazzon,Enrico Cárcamo,Daniel Jurado,Felipe Lara,Lorena Arévalo,Mirya Rojas,Diego Stephens,Gloria Hoppe,Arnold Brunser,Alejandro Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores
description	Background: Acute ischemic stroke (AIS) is one of the leading causes of death in Chile. Intravenous thrombolysis (IVT) is an effective treatment. Geographical barriers and lack of specialists limit its application. Telemedicine can overcome some of these pitfalls. Aim: To describe the implementation and results of AIS treatment by telemedicine at the TeleStroke Unit (TeleACV) of the Southern Metropolitan Health Service, connected with seven hospitals in Chile. Material and Methods: Descriptive analysis of a prospective tele-thrombolysis data-base that covers from 2016 to 2018, with an emphasis in the last year. Results: During the analyzed period, seven remote telemedicine centers were activated as far as 830 kilometers on a continental level from the reference center and up to 3,700 kilometers on an island level. There were 1,024 telemedicine consultations, 144 (14%) of them resulted in an IVT treatment. During 2018, 597 tele-consultations were made, thrombolysis was done in 115 (19%) patients aged 66+-13 years; 54 (46.6%) being female. The median admission National Institute of Health Stroke Scale was 8 (interquartile range (IQR) 5-14). The median door-to-needle time was 56.5 (IQR 44.8-73.3) minutes; 60% of patients were treated within 60 minutes. Eight patients (7%) were referred for a subsequent mechanical thrombectomy to a center of greater complexity. Symptomatic intra-cranial hemorrhages occurred in four treated patients (4%). One patient had a systemic bleeding. Conclusions: The Telestroke Unit achieved a high rate of IVT and good door-to-needle times. This may help to overcome some of the geographic barriers and the specialist availability gap in our country.
author	Mansilla,Eloy Mazzon,Enrico Cárcamo,Daniel Jurado,Felipe Lara,Lorena Arévalo,Mirya Rojas,Diego Stephens,Gloria Hoppe,Arnold Brunser,Alejandro
author_facet	Mansilla,Eloy Mazzon,Enrico Cárcamo,Daniel Jurado,Felipe Lara,Lorena Arévalo,Mirya Rojas,Diego Stephens,Gloria Hoppe,Arnold Brunser,Alejandro
author_sort	Mansilla,Eloy
title	Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores
title_short	Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores
title_full	Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores
title_fullStr	Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores
title_full_unstemmed	Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores
title_sort	telestroke en chile: resultados de 1 año de experiencia de la unidad de teleacv del servicio de salud metropolitano sur en 7 hospitales ejecutores
publisher	Sociedad Médica de Santiago
publishDate	2019
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000901107
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Telestroke en Chile: resultados de 1 año de experiencia de la Unidad de TeleACV del Servicio de Salud Metropolitano Sur en 7 hospitales ejecutores

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