Abstract
Background
Acute ischemic stroke (AIS) is a leading cause of death and
disability and recombinant tissue plasminogen activator (tPA)
may significantly reduce the long-term impact if given timely.
A rapid assessment of the patient is therefore required.
Notwithstanding many hospitals lack the stroke expertise and
resources to timely manage patients. In this context,
telemedicine facilities could be useful. The aim of this study
was to perform a systematic review and meta-analysis to assess
if telemedicine can be used in order to manage patients with
AIS with a specific focus on the impact on mortality.
Methods
Longitudinal studies dealing with telemedicine facilities in
managing AIS conducted before April 15th 2014 and published
in English were searched in PubMed, Web of Knowledge and
Scopus. The meta-analysis was performed to assess the impact
of telemedicine versus standard approach in reducing
mortality. Relative risk (RR) with 95% Confidence Interval
was used to report results and the I2 to evaluate heterogeneity.
Results
Six studies were considered for the review for a total of 3,987
patients managed by either telemedicine (2,283) or standard
approach (1,704). Four articles were clinical trials and two
were cohort studies. Three studies addressed in-hospital
mortality while all six dealt with 90 days mortality. The
meta-analysis yielded a RR of 1.68 (95% CI 0.68–4.10) and
0.96 (95% CI 0.83–1.11) for in-hospital mortality and 90 days
mortality respectively, without heterogeneity. A subgroup
analysis considering only trials released a RR of 0.72 (95%
CI 0.14–3.58) and of 0.94 (95% CI 0.81–1.10) respectively.
Conclusion
Our review showed no significant differences in terms of
mortality between telemedicine and control groups even
though results may be not considered conclusive because of
the small number of studies. Because of these results and in the
light of current organizational shortages, telemedicine may be
used in order to manage patients with AIS.
Key messages
Telemedicine does not improve survival of patients with
acute ischemic stroke as no significant differences were
shown in-hospital and 90 days mortality between telemedicine
and standard approach
Telemedicine is as an important tool in order to overcome
organizational shortage but its impact on patients’ health
outcomes deserves to be further addressed by appropriate
studies
| Original language | English |
|---|---|
| Pages (from-to) | 200-200 |
| Number of pages | 1 |
| Journal | European Journal of Public Health |
| Publication status | Published - 2015 |
| Event | 8th European Public Health Conference - Milano Duration: 14 Oct 2015 → 17 Oct 2015 |
Keywords
- Systematic review
- Telestroke