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Tele-attack care in hospitals improves patient outcomes

By Ernie Mundell and Robert Preidt
HealthDay Reporters

TUESDAY, March 2, 2021 (HealthDay News) – You have had a stroke and arrive at the hospital, but the stroke specialist is not on duty. Don’t worry: telemedicine can save your life.

Especially during the COVID-19 crisis, so-called “ tele-attack ” services – where health workers use video to see a stroke specialist who may be miles away – are helping improve outcomes. patient outcomes, new research shows.

“Our findings provide important evidence that teleacting improves care and can save lives,” said lead author of the study Dr. Ateev Mehrotra, associate professor of health policy and medicine at Harvard. Medical School, in an academic press release.

The benefits of enhanced video care are greatest for rural Americans, added study co-author Andrew Wilcock, although many rural hospitals are not yet equipped for tele-attack services.

The findings “underscore the need to tackle the financial hurdles these small hospitals face by introducing the tele-attack,” said Wilcock, assistant professor of medicine at the University of Vermont and visiting healthcare policy researcher. at Harvard Medical School.


As the researchers explained, for patients with symptoms of stroke, “time is the brain.” This means that they require prompt assessment and treatment by experts to stop any brain damage and prevent severe disability or death.

But many hospitals do not have 24-hour stroke care teams. To compensate for this, nearly a third of US hospitals offer telemedicine consultations with stroke specialists at other facilities. , sometimes hundreds of kilometers.

How much does it help? To find out, the Harvard team compared results and 30-day survival among 150,000 stroke patients treated in more than 1,200 US hospitals. Half of the centers offered tele-attack services and half did not.

The study found that patients in hospitals with tele-attack received better care and were 4% more likely to be alive after 30 days than those in hospitals without tele-attack. The biggest benefits of telecare for stroke were evident in hospitals with the lowest patient volumes and those in rural areas, according to the study published online March 1 in JAMA Neurology.


The researchers also evaluated the use of “reperfusion” treatments, in which blood flow is restored to areas of the brain affected by stroke to prevent irreparable damage.

The rates of this treatment were 13% higher in patients in hospitals with telestroke care than in those in hospitals without telestroke services.

Two stroke experts unrelated to the study agreed that tele-attack services can save lives.

The results “confirm what several smaller studies have shown: that providing expert neurological stroke care via remote video technology can increase the number of patients receiving brain-saving clot treatments,” said Dr. Salman Azhar, who heads stroke care at Lenox Hill Hospital in New York. “My feeling is that this finding can be extrapolated to generally underserved hospitals where there is a shortage of stroke specialists.”

Dr Andrew Rogove is the head of stroke services at South Shore University Hospital in Bay Shore, New York. He agreed that the tele-attack reduces the risk of patients dying, but noted that the population of the study was relatively older, around 79 years on average.


“It would be interesting to see how telemedicine for stroke would affect outcomes in a younger population,” Rogove said.

More information

The American Stroke Association has more information on stroke treatment.

SOURCES: Salman Azhar, MD, director, stroke care, Lenox Hill Hospital, New York City; Andrew Rogove, MD, PhD, Medical Director, Stroke Services, South Shore University Hospital, Bay Shore, NY; Harvard Medical School, press release, March 1, 2021


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