Telestroke Outcomes and Challenges in a Lower-Middle-Income Country: Experience from the Swasthya Ingit Telestroke Program of West Bengal, India

作者：A. Dutta, Arnab Sarkar, Subhadeep Gupta, Uddalak Chakraborty, Chayan Mondal, Soumozit Banerjee, Deep Das, Debabrata Pulai, Alapan Paul, Snehansu Shekhar Samanta, Sujoy Sarkar, Susanta Chakrabarty, Chinmoy Barik, Diptak Bhowmick, Sanat Kumar Jatua, Snehasis Das, Samiran Misra, Biswajit Ray, Phalguni Das, Binod Das, Barun Das, Avijit Naskar, Dhiraj Roy, Bichitra Biswas, Amit Kumar Das, Dipanjan Das, Aniruddha Sarkar, Rabiul Alam, Kaushik Pal, Kalyan Kumar Das, S. Datta, Jishnu Bhattacharya, Somnath Ghosh, Sishir Kumar Naskar, Prasenjit Majumdar, Gautam Ghosh, Amit Dutta, Amit K. Ghosh, Souvik Sen, Soumya Ghosh, Nitai Chandra Mandal, Subhransu Sekhar Datta, Asit K. Biswas, Swapan Saren, Rahul Kumar, Shashvat Desai, Ashutosh P. Jadhav, Jeyaraj Pandian, Manimoy Bandopadhyay, Biman Kanti Ray · 发表于：Cerebrovascular Diseases · 年份：2025 · DOI：10.1159/000548264 · 被引用次数：1 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Telemedicine and Telehealth Implementation

INTRODUCTION: A global gap exists in access to standard care for ischemic stroke, including thrombolysis. Most thrombolysis-capable centers in India are located in major cities, making it difficult for many patients to reach them within the golden hour. Telemedicine can help facilitate thrombolysis in remote areas. This study aimed to evaluate the outcomes of patients who received thrombolysis under the Swasthya Ingit Telestroke Program in West Bengal, India, and to describe the challenges faced during the program. METHODS: This multicentric observational study analyzes secondary data collected from the Swasthya Ingit Telestroke Program. It compares the outcomes of patients who received thrombolysis in 32 hospitals that used teleconsultation (telemedicine group) with those treated in 9 hospitals where patients were thrombolyzed under the direct supervision of a neurologist (direct supervision group). Outcome comparisons included functional independence (modified Rankin scale [mRS] score of 0-2 at 90 days), all-cause mortality within 90 days, and symptomatic intracerebral hemorrhage (sICH). RESULTS: Since the start of the telestroke program in December 2021, 1,329 patients have received thrombolysis (1,034 in the "telemedicine group" and 295 in the "direct supervision group") through June 2024. After excluding patients without 90-day follow-up data, 1,145 patients were included in the analysis. The two groups showed no significant difference in good functional outcomes (mRS 0-...