Introduction
Method
Patient selection and baseline characteristics
Data analysis
Characteristic | Non-telestroke | Telestroke | P-value |
---|---|---|---|
(N = 180) | (N = 132) | ||
Patient age in years | |||
Mean ± SD | 69.3 ± 12.7 | 65.9 ± 12.3 | 0.020* |
Age group: no. (%) | |||
< 50 years | 14 (7.8) | 11 (8.3) | 0.069 |
50–59 | 26 (14.4) | 20 (15.2) | |
60–69 | 43 (23.9) | 49 (37.1) | |
70–79 | 54 (30) | 33 (25) | |
≥ 80 | 43 (23.9) | 19 (14.4) | |
Gender: no. (%) | |||
Male | 88 (48.9) | 69 (52.3) | 0.555 |
Female | 92 (51.1) | 63 (47.7) | |
Race: no. (%) | |||
Caucasian | 127 (70.6) | 102 (77.3) | 0.212 |
African-American | 32 (17.8) | 19 (14.4) | |
Other | 3 (1.7) | 3 (2.3) | |
Hispanic ethnicity: no. (%) | 5 (2.8) | 6 (4.5) | 0.403 |
Body mass index | |||
Mean ± SD | 29.5 ± 7.3 | 32.2 ± 7.5 | 0.001* |
Medical history: no. (%) | |||
Atrial fib/flutter | 39 (21.7) | 11 (8.3) | 0.002* |
Carotid artery stenosis | 12 (6.7) | 6 (4.5) | 0.427 |
Congestive heart failure | 28 (15.6) | 17 (12.9) | 0.506 |
Coronary artery disease | 80 (44.4) | 62 (47) | 0.658 |
Depression | 1 (0.6) | 27 (20.5) | < 0.001* |
Dyslipidemia | 124 (68.9) | 92 (69.7) | 0.879 |
Family history of stroke | 14 (7.8) | 24 (18.2) | 0.006* |
Hormone replacement therapy | 3 (1.7) | 3 (2.3) | 0.7 |
Hypertension | 165 (91.7) | 123 (93.2) | 0.62 |
Migraine | 5 (2.8) | 4 (3) | 0.895 |
Obesity | 78 (43.3) | 85 (64.4) | < 0.001* |
Peripheral vascular disease | 23 (12.8) | 11 (8.3) | 0.213 |
Previous stroke | 73 (40.6) | 31 (23.5) | 0.002* |
Previous TIA | 22 (12.2) | 9 (6.8) | 0.115 |
Prosthetic heart valve | 1 (0.6) | 0 (0) | 0.391 |
Renal insufficiency | 24 (13.3) | 9 (6.8) | 0.065 |
Sleep apnea | 0 (0) | 11 (8.3) | < 0.001* |
Smoking | 41 (22.8) | 25 (18.9) | 0.412 |
Substance abuse | 5 (2.8) | 2 (1.5) | 0.457 |
Initial NIH stroke scale | |||
Mean ± SD | 10.8 ± 8.6 | 8.9 ± 7.6 | 0.063 |
Initial labs and vitals | |||
Total cholesterol | 165.7 ± 56.9 | 165.1 ± 43.4 | 0.885 |
Triglycerides | 157.3 ± 118.4 | 159.3 ± 106.1 | 0.307 |
HDL | 39.4 ± 12.9 | 37.8 ± 11.7 | 0.565 |
LDL | 95.8 ± 36.5 | 98.4 ± 35.3 | 0.889 |
Lipids | 7.6 ± 2.1 | 7.6 ± 2.1 | 0.067 |
Blood glucose | 195.8 ± 115.2 | 173 ± 97 | 0.054 |
Creatinine | 1.5 ± 1.1 | 1.2 ± 1 | 0.007* |
INR | 1.1 ± 0.3 | 1 ± 0.2 | 0.074 |
Heart rate | 84.1 ± 19.2 | 80.4 ± 16.9 | 0.097 |
Systolic blood pressure | 155.9 ± 33.2 | 150.6 ± 23.6 | 0.158 |
Diastolic blood pressure | 81.8 ± 19.2 | 78.8 ± 17.1 | <0.001* |
Medications prior to admission: no. (%) | |||
Antiplatelet or anticoagulant | 112 (62.2) | 79 (59.8) | 0.671 |
Antihypertensive | 150 (83.3) | 114 (86.4) | 0.464 |
Cholesterol reducer | 113 (62.8) | 91 (68.9) | 0.258 |
Diabetic medication | 128 (71.1) | 100 (75.8) | 0.361 |
Ambulation status prior to event: no. (%) | |||
Ambulate independently | 148 (82.2) | 121 (91.7) | 0.106 |
Ambulate with assistance | 12 (6.7) | 3 (2.3) | |
Unable to ambulate | 11 (6.1) | 5 (3.8) | |
Not documented | 9 (5) | 3 (2.3) | |
Ambulation status on admission: no. (%) | |||
Ambulate independently | 20 (11.1) | 26 (19.7) | 0.016* |
Ambulate with assistance | 18 (10) | 23 (17.4) | |
Unable to ambulate | 75 (41.7) | 39 (29.5) | |
Not documented | 67 (37.2) | 44 (33.3) | |
Ambulation status on discharge: no. (%) | |||
Ambulate independently | 69 (38.3) | 61 (46.2) | 0.044* |
Ambulate with assistance | 46 (25.6) | 42 (31.8) | |
Unable to ambulate | 47 (26.1) | 18 (13.6) | |
Not documented | 18 (10) | 11 (8.3) | |
First care received: no. (%) | |||
Emergency department | 159 (88.3) | 38 (28.8) | < 0.001* |
Direct admission | 21 (11.7) | 94 (71.2) | |
rtPA administration | 68 (37.8) | 114 (86.4) | < 0.001* |
Improved ambulation | 109 (60.6) | 89 (67.4) | 0.213 |
Characteristic | Non-telestroke | Telestroke | ||||
---|---|---|---|---|---|---|
No rtPA | rtPA | P-value | No rtPA | rtPA | P-value | |
(N = 112) | (N = 68) | (N = 18) | (N = 114) | |||
Patient age in years | ||||||
Mean ± SD | 70.8 ± 12 | 66.8 ± 13.5 | 0.043* | 66.9 ± 13.2 | 65.8 ± 12.2 | 0.727 |
Age group: no. (%) | ||||||
< 50 years | 6 (5.4) | 8 (11.8) | 0.014 | 1 (5.6) | 10 (8.8) | 0.362 |
50–59 | 16 (14.3) | 10 (14.7) | 5 (27.8) | 15 (13.2) | ||
60–69 | 20 (17.9) | 23 (33.8) | 5 (27.8) | 44 (38.6) | ||
70–79 | 42 (37.5) | 12 (17.6) | 3 (16.7) | 30 (26.3) | ||
≥ 80 | 28 (25) | 15 (22.1) | 4 (22.2) | 15 (13.2) | ||
Gender: no. (%) | ||||||
Male | 49 (43.8) | 39 (57.4) | 0.077 | 9 (50) | 60 (52.6) | 0.835 |
Female | 63 (56.3) | 29 (42.6) | 9 (50) | 54 (47.4) | ||
Race: no. (%) | (0) | (0) | ||||
Caucasian | 73 (65.2) | 54 (79.4) | 0.6 | 14 (77.8) | 88 (77.2) | 0.74 |
African-American | 21 (18.8) | 11 (16.2) | 2 (11.1) | 17 (14.9) | ||
Other | 3 (2.7) | 0 (0) | 0 (0) | 3 (2.6) | ||
Hispanic ethnicity: no. (%) | 2 (1.8) | 3 (4.4) | 0.917 | 0 (0) | 6 (5.3) | 0.319 |
Body mass index | ||||||
Mean ± SD | 29.6 ± 7.6 | 29.1 ± 7 | 0.657 | 31 ± 7 | 32.4 ± 7.6 | 0.447 |
Medical history: no. (%) | ||||||
Atrial fib/flutter | 30 (26.8) | 9 (13.2) | 0.032 | 2 (11.1) | 9 (7.9) | 0.646 |
Carotid artery stenosis | 10 (8.9) | 2 (2.9) | 0.118 | 0 (0) | 6 (5.3) | 0.319 |
Congestive heart failure | 21 (18.8) | 7 (10.3) | 0.129 | 4 (22.2) | 13 (11.4) | 0.203 |
Coronary artery disease | 48 (42.9) | 32 (47.1) | 0.582 | 9 (50) | 53 (46.5) | 0.782 |
Depression | 1 (0.9) | 0 (0) | 0.435 | 3 (16.7) | 24 (21.1) | 0.668 |
Dyslipidemia | 76 (67.9) | 48 (70.6) | 0.701 | 13 (72.2) | 79 (69.3) | 0.802 |
Family history of stroke | 8 (7.1) | 6 (8.8) | 0.683 | 0 (0) | 24 (21.1) | 0.031 |
Hormone replacement therapy | 2 (1.8) | 1 (1.5) | 0.873 | 0 (0) | 3 (2.6) | 0.486 |
Hypertension | 103 (92) | 62 (91.2) | 0.853 | 16 (88.9) | 107 (93.9) | 0.437 |
Migraine | 1 (0.9) | 4 (5.9) | 0.048 | 1 (5.6) | 3 (2.6) | 0.501 |
Obesity | 48 (42.9) | 30 (44.1) | 0.869 | 12 (66.7) | 73 (64) | 0.828 |
Peripheral vascular disease | 17 (15.2) | 6 (8.8) | 0.216 | 1 (5.6) | 10 (8.8) | 0.646 |
Previous stroke | 50 (44.6) | 23 (33.8) | 0.152 | 5 (27.8) | 26 (22.8) | 0.644 |
Previous TIA | 13 (11.6) | 9 (13.2) | 0.746 | 2 (11.1) | 7 (6.1) | 0.437 |
Prosthetic heart valve | 1 (0.9) | 0 (0) | 0.435 | (0) | (0) | |
Renal insufficiency | 20 (17.9) | 4 (5.9) | 0.022 | 1 (5.6) | 8 (7) | 0.819 |
Smoking | 23 (20.5) | 18 (26.5) | 0.357 | 4 (22.2) | 21 (18.4) | 0.702 |
Substance abuse | 2 (1.8) | 3 (4.4) | 0.299 | 0 (0) | 2 (1.8) | 0.571 |
Initial NIH stroke scale | ||||||
Mean ± SD | 10.3 ± 9.2 | 11.3 ± 7.8 | 0.462 | 10.7 ± 9.4 | 8.6 ± 7.4 | 0.34 |
Initial labs and vitals | ||||||
Total cholesterol | 168.1 ± 62.8 | 162.4 ± 48.4 | 0.547 | 160.9 ± 53 | 165.7 ± 42 | 0.682 |
Triglycerides | 157.6 ± 125.1 | 157 ± 109.7 | 0.976 | 128.4 ± 68.7 | 163.9 ± 110.1 | 0.213 |
HDL | 40.2 ± 14.1 | 38.3 ± 11 | 0.379 | 38.4 ± 13.5 | 37.8 ± 11.5 | 0.843 |
LDL | 95.2 ± 34.3 | 96.6 ± 39.4 | 0.816 | 98.9 ± 50.6 | 98.3 ± 32.7 | 0.945 |
Lipids | 7.8 ± 2.2 | 7.3 ± 1.9 | 0.171 | 7.6 ± 2.4 | 7.6 ± 2.1 | 0.945 |
Blood glucose | 210.9 ± 126.8 | 171 ± 88.3 | 0.014* | 184.2 ± 133.1 | 171.3 ± 90.6 | 0.602 |
Creatinine | 1.6 ± 1.3 | 1.3 ± 0.7 | 0.032* | 1.6 ± 2.3 | 1.2 ± 0.6 | 0.375 |
INR | 1.2 ± 0.4 | 1.1 ± 0.1 | 0.002* | 1.2 ± 0.5 | 1 ± 0.1 | 0.347 |
Heart rate | 85.5 ± 21.2 | 81.8 ± 15.2 | 0.216 | 77.9 ± 15.4 | 80.8 ± 17.1 | 0.505 |
Systolic blood pressure | 155.1 ± 35 | 157.3 ± 30.1 | 0.669 | 151.7 ± 22 | 150.4 ± 24 | 0.835 |
Diastolic blood pressure | 82.5 ± 20.6 | 80.7 ± 16.8 | 0.555 | 77.8 ± 14.4 | 79 ± 17.5 | 0.779 |
Medications prior to admission: no. (%) | ||||||
Antiplatelet or anticoagulant | 72 (64.3) | 40 (58.8) | 0.464 | 12 (66.7) | 67 (58.8) | 0.525 |
Antihypertensive | 93 (83) | 57 (83.8) | 0.891 | 14 (77.8) | 100 (87.7) | 0.253 |
Cholesterol reducer | 70 (62.5) | 43 (63.2) | 0.921 | 15 (83.3) | 76 (66.7) | 0.156 |
Diabetic medication | 78 (69.6) | 50 (73.5) | 0.577 | 12 (66.7) | 88 (77.2) | 0.333 |
Ambulation status prior to event: no. (%) | (0) | (0) | ||||
Ambulate independently | 85 (75.9) | 63 (92.6) | 0.028* | 15 (83.3) | 106 (93) | 0.511 |
Ambulate with assistance | 11 (9.8) | 1 (1.5) | 1 (5.6) | 2 (1.8) | ||
Unable to ambulate | 8 (7.1) | 3 (4.4) | (0) | 4 (3.5) | ||
Not documented | 8 (7.1) | 1 (1.5) | (0) | 2 (1.8) | ||
Ambulation status on admission: no. (%) | (0) | (0) | ||||
Ambulate independently | 16 (14.3) | 4 (5.9) | 0.107 | 6 (33.3) | 20 (17.5) | 0.016* |
Ambulate with assistance | 14 (12.5) | 4 (5.9) | 0 (0) | 23 (20.2) | ||
Unable to ambulate | 45 (40.2) | 30 (44.1) | 9 (50) | 30 (26.3) | ||
Not documented | 37 (33) | 30 (44.1) | 3 (16.7) | 41 (36) | ||
Ambulation status on discharge: no. (%) | ||||||
Ambulate independently | 39 (34.8) | 30 (44.1) | 0.223 | 9 (50) | 52 (45.6) | 0.328 |
Ambulate With assistance | 29 (25.9) | 17 (25) | 3 (16.7) | 39 (34.2) | ||
Unable to ambulate | 29 (25.9) | 18 (26.5) | 3 (16.7) | 15 (13.2) | ||
Not documented | 15 (13.4) | 3 (4.4) | 3 (16.7) | 8 (7) | ||
First care received: no. (%) | ||||||
Emergency department | 100 (89.3) | 59 (86.8) | 0.609 | 12 (66.7) | 26 (22.8) | < 0.001* |
Direct admission | 12 (10.7) | 9 (13.2) | 6 (33.3) | 88 (77.2) | ||
Improved ambulation | 63 (56.3) | 46 (67.6) | 0.129 | 14 (77.8) | 75 (65.8) | 0.313 |
B value | Adj. odds ratio | Wald | P value | |
---|---|---|---|---|
INR | − 1.971 | 0.139 (0.029–0.67) | 6.054 | 0.014* |
Congestive heart failure | − 1.111 | 0.329 (0.124–0.878) | 4.930 | 0.026* |
Direct admission | 1.145 | 3.141 (1–9.867) | 3.842 | 0.050 |
Telestroke | 1.583 | 4.87 (1.834–12.928) | 10.097 | 0.001* |
Constant | 2.256 | 9.541 | 6.418 | 0.011* |
B value | Adj. odds ratio | Wald | P value | |
---|---|---|---|---|
Higher age | − 0.046 | 0.955 (0.922–0.989) | 6.797 | 0.009* |
NIH stroke scale | 0.066 | 1.068 (1.009–1.13) | 5.190 | 0.023* |
Blood glucose level | − 0.006 | 0.994 (0.99–0.999) | 6.037 | 0.014* |
INR | − 2.180 | 0.113 (0.014–0.944) | 4.054 | 0.044* |
Renal insufficiency | − 1.817 | 0.163 (0.033–0.791) | 5.064 | 0.024* |
Constant | 6.225 | 505.460 | 11.330 | 0.001* |
B value | Adj. odds ratio | Wald | P value | |
---|---|---|---|---|
INR | − 2.758 | 0.063 (0.003–1.347) | 3.130 | 0.077 |
Constant | 5.155 | 173.322 | 8.724 | 0.003* |