Telestroke activity across Europe; The results of a European Stroke Organization survey

Daniel J. Ryan, Peter Mueller-Barna, Rascha von Martial, Francesco Corea, Bojana Zvan, Ž. Živanović, Jesicaa Barlinn, Milena Krasinska-Chavez, Andrey Alasheev
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Abstract

Telestroke care is likely not inferior to face-to-face care in acute stroke management while it also provides rural sites with access to specialist expertise. However, little is known about the distribution and activity of telestroke networks across Europe. Consequently, the European Stroke Organization (ESO) Telestroke Committee aimed to address this through an online questionnaire.The questionnaire was developed through an unstructured consensus process, ratified by the ESO Executive Committee, and emailed to ESO members.Of 2,147 ESO members contacted, complete data sets were submitted on 25 networks from 10 countries. Among the 25 networks, the mean number of hubs per network was 1.6 (SD 1.2), and the mean number of spokes was 9 (SD 6.7), with considerable variability observed (range 2–24 spokes/network). All sites used audiovisual communication. The mean telemedicine consultations per year per site was 197 (SD 164). The primary reason for consultation was “diagnostic and triage purposes” in all but one network. The median number of strokes per site was 175 (interquartile range 192), and the mean intervention rate was 12.3% (SD 10; thrombolysis or thrombectomy).At 25 networks, this survey probably underrepresents telestroke activity across Europe, yet it is still the first study to provide a continent-wide geographical footprint and report on activity within the networks. There was considerable variability in network size and activity. Spoke sites reported an acceptable intervention rate of 12.3%. This percentage compares favorably with national data from European countries and suggests telestroke care supports reasonable intervention rates.
欧洲远程卒中活动;欧洲卒中组织调查结果
远程卒中治疗在急性卒中管理方面可能并不逊色于面对面的治疗,同时它还能为农村地区提供获得专业技术的途径。然而,人们对欧洲远程卒中网络的分布和活动知之甚少。因此,欧洲卒中组织(ESO)远程卒中委员会旨在通过在线问卷调查来解决这一问题。该问卷是通过非结构化的共识过程制定的,经ESO执行委员会批准后通过电子邮件发送给ESO成员。在这 25 个网络中,每个网络的枢纽平均数量为 1.6 个(标准差为 1.2 个),辐条平均数量为 9 个(标准差为 6.7 个),但差异很大(范围为 2-24 个辐条/网络)。所有站点均使用视听通信。每个站点每年的平均远程医疗会诊次数为 197 次(标准差为 164 次)。除一个网络外,其他所有网络的主要会诊原因均为 "诊断和分诊目的"。每个站点的中风次数中位数为 175 次(四分位数间距为 192 次),平均干预率为 12.3%(标准差为 10 次;溶栓或血栓切除术)。这项调查共涉及 25 个网络,可能不足以反映整个欧洲的远程中风活动,但它仍然是第一项提供全欧洲地理足迹并报告网络内活动的研究。在网络规模和活动方面存在相当大的差异。据报告,可接受的干预率为 12.3%。这一比例与欧洲各国的国家数据相比毫不逊色,表明远程卒中护理支持合理的干预率。
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