ArticleStroke2010
Remote supervision of IV-tPA for acute ischemic stroke by telemedicine or telephone before transfer to a regional stroke center is feasible and safe.
Article in Stroke, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 151 citations in OpenAlex.
- Is telestroke more effective than conventional treatment for acute ischemic stroke? A systematic review and meta-analysis of patient outcomes and thrombolysis rates.International journal of stroke : official journal of the International Stroke Society · 2024Pooled it
- Stroke: working toward a prioritized world agenda.Cerebrovascular diseases (Basel, Switzerland) · 2010Guideline
- Observational study of telephone consults by stroke experts supporting community tissue plasminogen activator delivery.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2012Trial
- Assessment of long-term outcomes for the STRokE DOC telemedicine trial.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2012Trial
- Teleneurology: is it really at a distance?Journal of neurology · 2011Trial
- The Role of Videoconferencing Teleconsultation in Improving Transfer Efficiency and Functional Outcomes in Rural Stroke Care: Retrospective Cohort Study.JMIR mHealth and uHealth · 2026Article
- Global stroke statistics 2023: Availability of reperfusion services around the world.International journal of stroke : official journal of the International Stroke Society · 2024Review
- Teleconsultations in neurology in a universal health system amid COVID-19: a descriptive study.Revista da Associacao Medica Brasileira (1992) · 2022Article
- Comparison of Physical and Digital Treatment and Documentation of Uncomplicated Cystitis.Cureus · 2021Article
- A case of acute cerebral infarction with a favorable prognosis after rt-PA administration by a general physician with telestroke support.Journal of rural medicine : JRM · 2021Article
- Appropriateness, safety, and effectiveness of "drip and ship" teleconsultation model in Southeastern Tuscany: a feasibility study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2020Article
- Article
- Trends in Telestroke Care Delivery: A 15-Year Experience of an Academic Hub and Its Network of Spokes.Circulation. Cardiovascular quality and outcomes · 2020Article
- Outcomes of thrombolytic therapy in acute ischemic stroke: mothership, drip-and-ship, and ship-and-drip paradigms.BMC neurology · 2020Article
- Impact of Statewide Telestroke Network on Acute Stroke Treatment in Hawai'i.Hawai'i journal of health & social welfare · 2019Article
- Article
- Observational
- [Telemedicine in stroke care].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2017Review
- The American Heart Association's Get With the Guidelines (GWTG)-Stroke development and impact on stroke care.Stroke and vascular neurology · 2017Review
- Two Paradigms for Endovascular Thrombectomy After Intravenous Thrombolysis for Acute Ischemic Stroke.JAMA neurology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
background and purposeBecause of a shortage of stroke specialists, many outlying or "spoke" hospitals initiate intravenous (IV) thrombolysis using telemedicine or telephone consultation before transferring patients to a regional stroke center (RSC) hub. We analyzed complications and outcomes of patients treated with IV tissue plasminogen activator (tPA) using the "drip and ship" approach compared to those treated directly at the RSC.
methodsA retrospective review of our Get With the Guidelines Stroke (GWTG-Stroke) database from 01/2003 to 03/2008 identified 296 patients who received IV tPA within 3 hours of symptom onset without catheter-based reperfusion. GWTG-Stroke definitions for symptomatic intracranial (sICH), systemic hemorrhage, discharge functional status, and destination were applied. Follow-up modified Rankin Score was recorded when available.
resultsOf 296 patients, 181 (61.1%) had tPA infusion started at an outside spoke hospital (OSH) and 115 (38.9%) at the RSC hub. OSH patients were younger with fewer severe strokes than RSC patients. Patients treated based on telestroke were more frequently octogenarians than patients treated based on a telephone consult. Mortality, sICH, and functional outcomes were not different between OSH versus RSC and telephone versus telestroke patients. Among survivors, mean length of stay was shorter for OSH patients but discharge status was similar and 75% of patients walked independently at discharge.
conclusionsOutcomes in OSH "drip and ship" patients treated in a hub-and-spoke network were comparable to those treated directly at an RSC. These data suggest that "drip and ship" is a safe and effective method to shorten time to treatment with IV tPA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.