title: [Endovenous thrombolysis in a district hospital using the telestroke system].
abstract: BACKGROUND
  In January 2007, a telestroke system was established between a community hospital lacking a neurologist on call and a stroke centre 70 km away for acute stroke care.
  
  
  OBJECTIVE
  To study the impact of a telemedicine system for acute stroke care in a community hospital and the security of thrombolytic treatment.
  
  
  METHODS
  Observational study of acute stroke patients attended in the emergency room in a community hospital between 2007 and 2010.
  
  
  RESULTS
  662 acute stroke patients were attended. 133 'tele-consults' were done (37.6% ischemic stroke established). 39 patients (29.3%) were transferred to the stroke centre, 5 (12.8%) of them were considered unnecessary. 46 patients received thrombolytic treatment in the community hospital. The average time door-needle was 53.4 ± 38.2 minutes. 60.9% patients were treated during the first three hours since symptoms onset, and 100% in less than 4.5 hours. 9 patients received intra-arterial treatment. 4 patients (8.69%) presented hemorrhagic transformation 2 (4.3%) were symptomatic. 71.7% presented neurological improvement in 24 hours. 53.65% were functionally independent (mRS equal or less than 2) to three months. The mortality was 10.86%.
  
  
  CONCLUSIONS
  Tele-stroke allows a specialized attention for acute stroke in a community hospital, to administer thrombolytic treatment and could be an indispensable tool for select patient to transfer to the stroke centre for intra-arterial rescue procedures.
authors: Servicio de Medicina Interna, Consorci Hospitalari de Vic, España. iaiols@hotmail.com
authors: A
authors: A
authors: Pedragosa
authors: J
authors: J
authors: Alvarez-Sabín
authors: C A
authors: CA
authors: Molina
authors: J
authors: J
authors: Brugués
authors: M
authors: M
authors: Ribó
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006767:Hospitals, District; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy*; D017216:Telemedicine / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator