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Abstract Details

Telestroke Care for Acute Ischemic Stroke Patients Admitted to a Comprehensive Stroke Center During the COVID-19 Pandemic: TELECAST-CSC
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (11:45 AM-12:45 PM)
The COVID-19 pandemic disrupted specialist stroke care.  New barriers to healthcare delivery including physical distancing, personal protective equipment shortages, and provider illness may be surmountable through telemedicine, however, the efficacy of telestroke for inpatient management of AIS patients at CSCs is unknown.
To compare conventional, inpatient acute ischemic stroke (AIS) care with telestroke inpatient AIS care at a comprehensive stroke center (CSC).

TELECAST-CSC is a pre-post study examining AIS care at a single CSC.  All patients with a clinical or radiographic diagnosis of AIS were included.  In the first phase (December 1, 2019-March 15, 2020), all inpatient stroke specialist care was delivered conventionally in-person; in the second phase (March 16, 2020-June 29, 2020) all inpatient stroke specialist care was delivered via telestroke.  

The primary outcome was the composite adherence rate to AHA guidelines for inpatient AIS care.  Secondary outcomes were adherence rates for subcategories of the primary outcome and 30- and 90-day rates of readmission and recurrent cerebrovascular events.  

One hundred forty-four patients were included in the “in-person” cohort and 141 patients in the “telestroke” cohort (overall median age 72 [IQR 61-82], median NIHSS 2 [IQR 0-8], 17.2% received thrombolysis, 10.2% received thrombectomy).  There was no difference in adherence AHA guidelines for inpatient AIS care between the in-person and telestroke cohorts (96.9% vs 96.3%, p=0.26), or any subcategories of the primary outcome.  There was no difference in readmission rates within 30 days (11.8­­­­­­­­­­%, vs. 13.5%, p>0.999) and 90-days (18.8% vs 19.2%, p>0.999) or rates of recurrent stroke within 30 days (2.1% vs 2.1%, p>0.999) and 90 days (3.5% vs. 3.6%, p>0.999) for the in-person and telestroke cohorts, respectively.

At an academic CSC adherence to AHA guidelines for inpatient AIS were similar when care was delivered in-person or exclusively via telestroke, without differences in recurrent stroke or readmission rates between cohorts.
Solmaz Ramezani Hashtjin, MD (University of Minnesota)
Dr. Ramezani Hashtjin has nothing to disclose.
Adam R. Lipschultz, MD (University of Minnesota) Dr. Lipschultz has nothing to disclose.
Monica Ngo, MD (University of Minnesota Medical School - Twin Cities) Dr. Ngo has nothing to disclose.
Jodi Mueller-Hussein Jodi Mueller-Hussein has nothing to disclose.
Apameh Salari, MD Dr. Salari has nothing to disclose.
Collin D. Gradin, MD Mr. Gradin has nothing to disclose.
Kathryn Bard, PA (MPhysicians) Ms. Bard has nothing to disclose.
Amelia Solei, NP Mrs. Solei has nothing to disclose.
Nasima Omar, PA (University of Minnesota) Miss Omar has nothing to disclose.
Sarah A. Engkjer, RN (Minnesota Epilepsy Group) No disclosure on file
Oladi S. Bentho, MD (University of Minnesota) Dr. Bentho has nothing to disclose.
Christine E. Yeager, MD (Rush University Medical Center) Dr. Yeager has nothing to disclose.
Benjamin R. Miller, MD (University of Minnesota) The institution of Dr. Miller has received research support from StrokeNET.
Christopher Streib, MD (Department of Neurology) Dr. Streib has nothing to disclose.