The aim of this abstract is to examine the benefits of Telestroke usage and encourage widespread implementation.

The Get With The Guidelines™-Stroke registry at hospital site, was utilized for this study. Patients arriving within 4.5 hours of last known well time (LKWT) and discharged between 1/1/2021-12/31/2024 are included. Patients evaluated between 7pm-7am were included as stroke coverage in house was unavailable. Covariates included were age, race/ethnicity, sex, transfer status, mode of arrival, diagnosis time of arrival, and initial NIHSS. Logistic and linear regressions were used to analyze the data; results are presented as adjusted odds ratios. The independent variable was Telestroke utilization and the main dependent variables were CT to tPA administration time, arrival to tPA administration (DTN) time, and rate of tPA administration. 

235 patients met the inclusion criteria with 51 patients receiving tPA (Tables 1 and 2) 

This study suggests a benefit for utilizing Telestroke services. A direct comparison of door to needle, door to imaging, and imaging to thrombolytic times show an improvement with Telestroke.  Although no statistical significance is demonstrated, this may be secondary to a small sample size. It is evident that having available a stroke specialist can hasten diagnostic testing and rapid plan for treatment. These findings are inherent in the faster door to imaging and imaging to thrombolytic times. This is particularly applicable to additional hospital sites in the NYCHHC system without 24-hour stroke coverage. Limitations to analysis include lack of data in insurance status, preferred language,  and small sample.