5 research outputs found
Appropriateness, safety, and effectiveness of âdrip and shipâ teleconsultation model in Southeastern Tuscany: a feasibility study
Purpose: Teleconsultation is a consultation between two or more physicians about the diagnostic work-up and therapeutic strategy in the treatment of an individual case by means of modern telematics. âDrip-and-shipâ teleconsultation model consists of the transfer of patients, through telematics stroke networks, with large arteries occlusions from primary to comprehensive stroke centers equipped for endovascular therapy. We retrospectively investigated appropriateness, safety, and effectiveness of âdrip-and-shipâ teleconsultation model in a rural area of Tuscany. Methods: Outcome measures were: door-to-ship time (including door-to-needle time), ratio of number treated/total sent patients, adverse events/mortality during transfer, and mortality and modified Rankin scale at 90 days. Analysis of non-treated patients was also done. Results: Seventy-eight patients were included; 16/78 patients were sent for endovascular therapy alone, and 62/78 for âdrip-and-shipâ; 12 patients were not treated. Door-to-ship, and door-to-needle times (mean ± SD) were 105 ± 29.8 and 62.5 ± 37.5 min, respectively. The ratio number of treated/total sent patients was 0.85. At 90 days, the global mortality rate was 21%, and 40% of patients showed favorable outcome. The main cause of non-treatment was spontaneous recanalization. Conclusions: The high value for treated/total sent patientsâ ratio underlines that âdrip-and-shipâ teleconsultation model is appropriate and effective, with a few untreated patients. The model is safe, without adverse events during transfer. Taken together, our outcomes are in line with the previous reports. âDrip-and-shipâ teleconsultation model is safe and effective in rural areas, allowing good selections and rapid treatments for stroke patients, based on the transfer from the primary to the comprehensive stroke center