Health Technology Assessment, Ludwig Boltzmann Institute, Garnisongasse 7/20, A-1090 Vienna, Austria.
J Telemed Telecare. 2011;17(5):268-72. doi: 10.1258/jtt.2011.101213.
We conducted a retrospective controlled study to assess the safety and effectiveness of intravenous thrombolysis via videoconferencing, followed by patient transport to a specialized stroke unit. Between 2006 and 2009, 47 stroke patients were treated in peripheral hospitals in the county of Salzburg in Austria by intravenous thrombolysis via telemedicine; 304 patients who were treated with intravenous thrombolysis at a stroke unit served as the control group. The mean age of the patients was 67 years in the telemedicine group and 71 years in the control group. Haemorrhagic bleeding occurred in 6.4% of the telemedicine group compared to 7.6% of the control group. The mean onset-to-needle time was 113 min in the telemedicine group and 122 min in the control group (P = 0.263). At three-month follow-up, 47% of the patients in the telemedicine group had good functional outcomes (mRS, dichotomized analysis 0-1) versus 43% in the control group (P = 0.694). The overall mortality at three-month follow-up was 19% in the telemedicine group and 13% in the control group (P = 0.248). Telemedicine can be used to support regional areas with little experience in delivering intravenous thrombolysis, thus raising the standard of stroke care and minimizing inequalities.
我们进行了一项回顾性对照研究，以评估通过视频会议进行静脉溶栓治疗，然后将患者转运至专门的卒中单元的安全性和有效性。在 2006 年至 2009 年期间，奥地利萨尔茨堡县的 47 例卒中患者在县内的基层医院通过远程医疗接受了静脉溶栓治疗；304 例在卒中单元接受静脉溶栓治疗的患者作为对照组。远程医疗组患者的平均年龄为 67 岁，对照组为 71 岁。远程医疗组出现出血性出血的比例为 6.4%，对照组为 7.6%。远程医疗组的平均发病至溶栓时间为 113 分钟，对照组为 122 分钟（P=0.263）。在 3 个月的随访中，远程医疗组有 47%的患者功能结局良好（mRS，二分类分析 0-1），对照组为 43%（P=0.694）。远程医疗组的 3 个月随访总体死亡率为 19%，对照组为 13%（P=0.248）。远程医疗可用于支持在提供静脉溶栓治疗方面经验较少的地区，从而提高卒中护理的标准并最大限度地减少不平等现象。
