Experience of providing medical care for patients with stroke in teleconsulted stroke units in the Sverdlovsk region.

Abstract

Introduction. One of the problems of providing specialized care for ischemic stroke is to achieve high rates of intravenous thrombolytic therapy (IVT) in areas characterized by low population density and large distance from the nearest stroke unit (delivery time more than 1 h). In Sverdlovsk region, in order to solve this problem in such territories, three teleconsulted stroke units equipped with CT scanners and having resuscitation beds were organized in 2021. Objective. To study the dynamics of the rates of intravenous thrombolytic therapy for ischemic stroke in the territories with a teleconsulted stroke units (in addition to the stroke unit). Materials and Methods. We retrospectively analyzed the data of 85 patients treated in three teleconsulted stroke units (teleSU) of the Sverdlovsk region in 2022 and compared the dynamics of the increase in the IVT rate (R parameter,%/year) in these territories in comparison with the rest of the municipalities of the Sverdlovsk region. Results. According to the results of the study, it was found that the rate of IVT in teleSU was 9,0%, which is generally higher than the average value in the Sverdlovsk Region (5,1%) in the analyzed period. The analysis of the statistical data from 2020 to 2022 revealed that establishment of additional teleconsulted stroke units in the territories with low population density in 2022 has led to the increase of the number of procedures of IVT for ischemic stroke. Dynamics of growth of this indicator, became equale of that in the rest of the municipalities of the region. Conclusions. The organization of teleSU in addition to the main SU in the territories with low population density allows to increase the availability of specialized medical care and to increase the IVT rate in patients with ischemic stroke.