[Telestroke in Chile: 1 year experience at 7 hospitals]

Area of Science:

• Neurology
• Telemedicine
• Public Health

Background:

• Acute ischemic stroke (AIS) is a major cause of mortality in Chile.
• Geographical barriers and limited specialist availability hinder effective treatment like intravenous thrombolysis (IVT).
• Telemedicine offers a potential solution to overcome these access limitations.

Purpose of the Study:

• To detail the implementation and outcomes of AIS treatment via telemedicine.
• To evaluate the performance of the TeleStroke Unit (TeleACV) serving seven hospitals in Chile.
• To assess the impact of telemedicine on IVT delivery and patient outcomes.

Main Methods:

• A descriptive analysis of a prospective tele-thrombolysis database from 2016 to 2018 was conducted.
• Data focused on telemedicine consultations and IVT administration in remote and island-level hospitals.
• Emphasis was placed on the final year of data collection (2018).

Main Results:

• 1,024 telemedicine consultations were performed, leading to 144 (14%) IVT treatments.
• In 2018, 597 consultations resulted in 115 IVTs, with a median door-to-needle time of 56.5 minutes.
• 60% of patients received IVT within 60 minutes; 7% were referred for mechanical thrombectomy, with a 4% symptomatic intracranial hemorrhage rate.

Conclusions:

• The TeleStroke Unit demonstrated a high rate of successful IVT and achieved favorable door-to-needle times.
• Telemedicine effectively addressed geographical barriers and specialist shortages in stroke care within Chile.
• This model shows promise for expanding access to time-sensitive AIS treatments nationwide.