Thrombolytic treatment to stroke mimic patients via telestroke.
OBJECTIVE
The safety and outcomes of intravenous thrombolysis (IVT) to stroke patients via telestroke (TS) is similar to those presenting to stroke centers. Little is known on the accuracy of TS diagnosis among those receiving IVT. We sought to compare the rate of patients receiving IVT with diagnosis of ischemic stroke as opposed to stroke mimic (SM) in our TS network to those who presented to our comprehensive stroke center (CSC).


MATERIALS AND METHODS
Consecutive patients receiving IVT between August 2014 and June 2015 were identified at our CSC and TS network. We compared rates of SM, post-IVT symptomatic intracerebral hemorrhage (sICH), in-hospital mortality, and discharge destination.


RESULTS
We evaluated 131 receiving IVT were included in the analysis. Rates of SM receiving IVT were similar (CSC 12% versus 7% TS, p=0.33). Four stroke patients experienced sICH or in-hospital mortality; neither were found among SM patients. Discharge destination was similar between stroke and SM patients (p=0.9). SM patients had higher diagnoses of migraine (p=0.05) and psychiatric illness (p<0.01).


CONCLUSION
The accuracy of diagnosing stroke in IVT-eligible patients evaluated via TS is similar to evaluations at our CSC. Continued efforts should be made to minimize exposure of SM patients to IVT in both settings.
['Asaithambi|Ganesh|G|', 'Castle|Amy L|AL|', 'Sperl|Michael A|MA|', 'Ravichandran|Jayashree|J|', 'Gupta|Aditi|A|', 'Ho|Bridget M|BM|', 'Hanson|Sandra K|SK|']
D000368:Aged D000369:Aged, 80 and over D002545:Brain Ischemia D005260:Female D005343:Fibrinolytic Agents D006801:Humans D008297:Male D008875:Middle Aged D010043:Outcome and Process Assessment, Health Care D020521:Stroke D017216:Telemedicine D015912:Thrombolytic Therapy D010959:Tissue Plasminogen Activator
Stroke Mimic Telestroke Thrombolysis Diagnosis Telemedicine