A comparative study on acute ischemic stroke patients receiving thrombolitic therapy: comparing patients who consult to emergency rooms directly, patients who consult by telestroke after thrombolitic therapy , and patients who are referred for the treatment of thrombolitic treatment through telestroke

Aim: It is important to develop early and effective treatment methods for patients with acute ischemic stroke. In this study, we examined the three-month mortality rates of the patients who directly visit the central emergency department with the pre-diagnosis of acute ischemic stroke, those who were brought to the stroke center by 112 teams to receive IV t-PA treatment from an external center, and those who received telestroke consultation-assisted IV t-PA treatment before being referred to the stroke center. We aimed to evaluate the time until treatment and clinical outcomes of patients who received iv t-PA treatment between delivery protocols. Material and Method: The files of 198 patients with ischemic stroke who applied to Bolu Abant İzzet Baysal University Training and Research Hospital Emergency Service between 01/01/2017-31/12/2020 were analyzed retrospectively. Results: The youngest patient in the study was 20 years old, while the oldest patient was 93 years old, with a mean age of 70.1±13.3%, and 56.6% of these patients were women. The most common risk factors were hypertension, atherosclerosis, diabetes mellitus and hyperlipidemia. Among the patients, 26.3% had a stroke due to large artery atherosclerosis and small vessel occlusion, while 17.2% had a cardioembolic stroke. When the NIHSS scores of the patients were examined, it was found that those with high mRS scores had significantly higher NIHSS scores. A significant decrease was observed in the 3rd month mRS scores compared to the development mRS score in the compared patient groups. When the recanalization times were analyzed according to the 3rd month mRS scores, it was seen that there was no significant difference between the groups. There was no significant difference in pretreatment and 3rd month mRS scores between patients who underwent thrombectomy and who did not. Conclusion: In acute ischemic stroke patients, transportation to the stroke center for endovascular treatment with drip and send method in a shorter time may help to improve the clinical outcomes of stroke. Conducting similar studies with larger numbers of cases may help to prove the importance of the drip and send model in stroke mortality. Keywords: acute ischemic stroke, drip and ship, intravenous thrombolytic therapy, endovascular thrombectomy, functional outcome.