Abstract TP53: The Frontiers In Stroke Care: The Disparities Of Telemedicine And Telestroke In Latin America

Introduction: Stroke is the second leading cause of death worldwide, with more than a third of these deaths occurring in low-middle income countries, including most of Latin America (LATAM). However, the stroke care systems in LATAM are limited compared to high-income countries. Telestroke is an electronic communication system to deliver medical services from one site to another. Despite the optimal results increasing intravenous thrombolysis and endovascular therapy rates, its use in LATAM is scarce. Objective: The study aims to describe the current state of telemedicine (TM) and telestroke (TS) clinical applications in LATAM. Methodology: We conducted a systematic review of the literature according to PRISMA guidelines in PubMed/MEDLINE, Cochrane-Library, and Google-Scholar. The search was limited to English/Spanish languages using the search terms “telemedicine,” “telehealth,” “teleneurology,” “telestroke,” “Latin America.” In addition, we included randomized control trials, meta-analyses, observational cohorts, and literature reviews. Results: We identified 1,396 articles. After the screening and assessment for eligibility, 37 articles satisfied the inclusion criteria and revealed mixed results. The search showed that TM is widely used in different internal medicine subspecialties in LATAM than TS in Neurology. For example, the term “telemedicine” revealed 1,149 articles, and “telestroke” only 170 articles. Most of the articles reported the feasibility of TS (n=35), but the controlled comparison of TS with conventional services was barely reported (n=2). Brazil (n=7), Chile (n=4), Colombia (n=7), and Mexico (n=4) are the countries with the highest number of TS publications in LATAM. Conclusions: The use of TS is underdeveloped in LATAM compared to TM. Therefore, the collaboration of health authorities and non-governmental institutions is essential to continue building stroke care systems with TS in LATAM.