Implementierung eines landesweiten telemedizinischen Schlaganfallnetzwerks

Background The aim to treat stroke patients in rural areas according to current guidelines, demographic changes and advances in acute stroke treatment requires an adoption of medical services. Material and Methods In 2016, a state-wide telestroke service was introduced in Rheinland-Pfalz. Service is carried out by all 6 supraregional stroke-units. Responsibility switches on a daily basis offering 24/7 service for regional stroke-units while meeting OPS criteria 8.98b. Regional stroke-units and hospitals treating acute stroke patients while being in line with predefined criteria can participate. Results The telestroke network started in April 2016 and initially consisted of 6 supraregional and 6 regional stroke-units. During the first year, 1568 patients were examined within the network. In 802 patients (51.2%) ischemic stroke was diagnosed while intracerebral hemorrhage was observed in 46 patients (2.9%) and transient ischemic attack in 319 patients (20.4%). Stroke mimics were diagnosed in 400 patients (25.5%). Median latency between hospital admission and onset of tele -neurological examination was 21 minutes (interquartilrange (IQR) 22 minutes) and median length of telestroke consultation was 24 minutes (IQR 22 minutes). Among patients with ischemic stroke 100 (12.5%) received iv-thrombolysis. Thrombectomy was performed in 37 patients (4.6%) after transferal to stroke centers. Conclusion Telestroke network appears to be a feasible approach towards state-wide supply with acute stroke care. Further analyses are needed especially to determine the impact on stroke outcome.