Abstract
Purpose: Our aim was to investigate whether stroke mobile telemedicine (SMT) should determine the outcome in acute ischemic stroke patients admitted to a regional hospital.
Methods: Our study was conducted in nine areas of Japan and included a total of 23 hospitals and-nine stroke centers in connection with 14 regional hospitals. In the first period, from June to August 2009, we continued the medical support system that had already been established in each area (non-SMT group). In the second period, from September 2009 to January 2010, we built a new medical support system using SMT (SMT group). We compared the frequency of favorable outcomes (modified Rankin scale 0–2), death one month after onset, and the usage ratio of intravenous thrombolysis using tPA (IV tPA) between the non-SMT and SMT groups.
Results: A total of 134 patients were admitted to the regional hospitals in this study. This group consisted of 66 patients (male: 35, median age: 81 years) in the non-SMT group and 68 patients (male: 32, median age: 78 years) in the SMT group. Ischemic stroke was found in 43 (65%) of the non-SMT group and 38 (56%) of the SMT group. Among the ischemic stroke patients who had a follow-up one month after admission, IV tPA was administered to 1 of 40 (3%) in the non-SMT group and 4 of 34 (12%) in the SMT group (p=0.173). Favorable outcomes were observed in 19 patients (48%) in the non-SMT group and 15 (44%) in the SMT group (p=0.818).
Conclusion: IV tPA was administered to 12% of the acute ischemic stroke patients, and the outcomes of the non-SMT and SMT groups were not significantly different. SMT may play an important role in reducing the disparity of stroke services in Japan.
