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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Shortening Time to Stroke Treatment Using Ambulance Telemedicine: TeleBAT
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Shortening Time to Stroke Treatment Using Ambulance Telemedicine: TeleBAT

机译：使用救护车远程医疗缩短中风治疗时间：TeleBAT

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Objective: Patients with ischemic stroke treated with tissue plasminogen activator (rt-PA) have better outcomes when treated closer to the time of symptom onset and within the 3-hour window. We previously demonstrated the clinical use of TeleBAT, a mobile telemedicine system for stroke. We tested the impact of that system on time to treatment for patients with acute stroke. Methods: Validity and reliability were tested by comparing neurologic examination scores obtained using our wireless system, which transmits video of a patient from a moving ambulance to desktop computers, with those obtained using the National Institute of Neurological Disorders and Stroke training videotape, TeleBAT validity and good interrater reliability were defined a priori as a kappa statistic of r > 0.5. We compared the average time to treatment for our TeleBAT-evaluated intervention group with that for our control group. The intervention group consisted of two actor patients with stroke mimicking 12 stroke scenarios and evaluated using TeleBAT. The control group consisted of patients with stroke evaluated and treated with rt-PA on arrival to the emergency department. Data were analyzed using standard t test, Results: National Institutes of Health Stroke Scale items calculated by the neurologists suggest TeleBAT is valid for assessing patients with stroke remotely. Interrater reliability was high: the neurologists gleaned the same information from TeleBAT transmissions. Kappa values for both validity and reliability exceeded 0.5. The mean time to treatment for patients assessed by TeleBAT was 17 (+-) 4 minutes compared with 33 (+-) 17 minutes for our control group (P =.0033). Conclusion: TeleBAT seems to be a valid and reliable means of evaluating stroke neurologic deficits. Time to treatment was shortened using ambulance transport time to evaluate patients as candidates for thrombolytic therapy. Future studies should use a randomized design with patients with acute stroke.
机译：目的：用组织纤溶酶原激活剂（rt-PA）治疗的缺血性中风患者在接近症状发作时间和3小时内接受治疗时，会获得更好的结果。我们先前演示了用于中风的移动远程医疗系统TeleBAT的临床使用。我们测试了该系统对急性中风患者及时治疗的影响。方法：通过比较使用我们无线系统获得的神经系统检查评分（其将患者从移动的救护车传输到台式计算机的视频）与使用美国国家神经系统疾病和中风训练录像带，TeleBAT有效性和先验的良好间位可靠性被定义为r> 0.5的kappa统计量。我们将TeleBAT评估的干预组与对照组的平均治疗时间进行了比较。干预组由两名中风模仿12种中风情景的演员患者组成，并使用TeleBAT进行了评估。对照组包括经过评估并在到达急诊室时接受rt-PA治疗的中风患者。使用标准t检验对数据进行了分析，结果：神经科医生计算出的国立卫生研究院卒中量表项目表明TeleBAT对于远程评估卒中患者有效。评估者之间的可靠性很高：神经科医生从TeleBAT传输中收集了相同的信息。有效性和可靠性的Kappa值均超过0.5。通过TeleBAT评估的患者的平均治疗时间为17（±）4分钟，而我们的对照组为33（±）17分钟（P = .0033）。结论：TeleBAT似乎是评估中风神经功能缺损的有效且可靠的方法。使用救护车运送时间来评估患者是否可以作为溶栓治疗的候选者，可以缩短治疗时间。未来的研究应该对急性中风患者使用随机设计。

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