Clinical trial NCT02902263: Inter-Hospital Transfer to a Vascular Neurology Unit After Telethrombolysis
Official title: Inter-Hospital Transfer to a Vascular Neurology Unit After Telethrombolysis in France Comté
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Ischemic Stroke
Keywords: Telemedecine
Thrombolysis
Lead sponsor: Centre Hospitalier Universitaire de Besancon
Sponsor class: OTHER
First posted: 2016-09-15
Enrollment: 79
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Consecutive patients admitted in one emergency departments of four peripheral hospital centres in Franche Comté (Pontarlier, Vesoul, Gray and Dôle).

Patients admitted for ischemic stroke, treated by thrombolysis and transferred to tue NVU

Brief summary: Early thrombolysis is essential in treating ischemic strokes. The time window for thrombolysis is limited to 4,5 hours after symptoms onset.

In the French region of Franche Comté, in order to reduce the thrombolytic delay, a telemedicine network was developed between the neurovascular reference unit (NVU) localised in the University Hospital of Besançon and the peripheral hospital centres. Patients may then be transported to the NVU immediately after the thrombolysis initiation.

The aim of our study was to assess the relevance of a systematic medicalization of transfer to the NVU of patients with stroke who were telethrombolyzed before.

It was a retrospective, monocentric and observational study conducted over 24 months, in Franche-Comte (France).

Detailed description: Stroke is a major health problem with increasing incidence. It represents the leading cause of disability and the third cause of death in France. There are two main types of stroke: ischemic (80%) or hemorrhagic (20%).

Early thrombolysis is essential in treating ischemic strokes. The time window for thrombolysis is limited to 4,5 hours after symptoms onset.

In the French region of Franche Comté, in order to reduce the thrombolytic delay, a telemedicine network was developed between the neurovascular reference unit (NVU) localised in the University Hospital of Besançon and the peripheral hospital centres. Patients may then be transported to the NVU immediately after the thrombolysis initiation.

The aim of our study was to assess the relevance of a systematic medicalization of transfer to the NVU of patients with stroke who were telethrombolyzed before.

It was a retrospective, monocentric and observational study conducted over 24 months, in Franche-Comte (France). Evaluation of neurological status was made with the Glasgow score (GCS) and National Institute of Health Stroke Score (NIHSS). The respiratory (SpO2; needs O2) and hemodynamic status (arterial blood pressure, heart rate) were assessed as well as the need for medical resuscitation at different times of the transport (thrombolysis, transfer, arrival at the Regional University Hospital Centre).

Eligibility criteria: Inclusion Criteria:

* Patient with ischaemic stroke
* Emergency department admission between 01/01/2012 and 12/31/2013
* Telemedicine stroke consult
* Thrombolysis therapy
* Patient transfered to NVU after thrombolysis initiation
* Transfer staffed by a qualified physician

Exclusion Criteria:

* Transfer non staffed by a qualified physician

Primary outcomes:
measure: Patient neurological status assessed by NIHSS score during transfer to NVU
timeFrame: one day
measure: Patient neurological status assessed by Glasgow score during transfer to NVU
timeFrame: one day
Secondary outcomes:
measure: Patient respiratory status assessed by oxygen saturation
timeFrame: one day
measure: Patient hemodynamic status assessed by systolic and diastolic pressure
timeFrame: one day
Other outcomes:
Locations:
city: Besançon
country: France
facility: CHRU Besancon
Study officials:
References:
citation: Nenert E, Pretalli JB, Bouamra B, Puyraveau M, Fehner L, Labourey JM, Desmettre T. Transfert interhospitalier vers une unité de neurologie vasculaire des accidents vasculaires cérébraux ischémiques téléthrombolysés : pertinence d'une médicalisation systématique ? Ann. Fr. Med. Urgence (2016).