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Master Thesis

Taux de traitement par thrombolyse IV et/ou thrombectomie mécanique dans l’infarctus cérébral aigu, disparités géographiques et évolution temporelle en Normandie Occidentale

Abstract : Background and purpose. In patients with acute ischaemic stroke, early recanalization with IV thrombolysis and/or mechanical thrombectomy correlates with good functional outcome. However, the accessibility to these treatments is heterogeneous and the use of telemedicine may reduce these geographical disparities. Method. Among the residents in Western Normandy hospitalized for an acute ischemic stroke in the hospitals of Western Normandy between January 2013 and December 2017, we determined the rate of treatment with IV thrombolysis or/and mechanical thrombectomy, overall and according to their place of residence. We also compared the treatment rate before (2013-2015) and after (2016-2017) the implementation of telemedicine in Western Normandy. Results. In 2013-2017, among the 10,733 stroke patients (mean age=72years, 51% of men), 893 (8%) were treated with IV thrombolysis and/or mechanical thrombectomy. The proportion of patients treated IV thrombolysis or/and mechanical thrombectomy ranged from 3% to 28%.The proportion of treated patients varied based on the place of residence, and was lower in the subgroup of patients living in rural area and further away from the hospitals. The rate of treatment significantly increased from 8% to 12% (p<0.001) since the implementation of telemedicine, while the baseline characteristics of patients remained unchanged between the two periods. Interestingly, the increase in treatment rate was observed in both rural and urban areas. Conclusion. The use of telemedicine seems to be an efficient way to reduce the geographical disparities in the accessibility to acute recanalization in stroke patients.
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Master Thesis
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Pierre Godeau. Taux de traitement par thrombolyse IV et/ou thrombectomie mécanique dans l’infarctus cérébral aigu, disparités géographiques et évolution temporelle en Normandie Occidentale. Médecine humaine et pathologie. 2019. ⟨dumas-02473860⟩

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