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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(05): s00451807719
DOI: 10.1055/s-0045-1807719
Original Article

Telemedicine transforming stroke care in Piauí: an analysis of a state-wide initiative's first year

Irapuá Ferreira Ricarte 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
2   Centro Universitário UNINOVAFAPI, Departamento de Ciências da Saúde, Teresina PI, Brazil.
,
Ícaro Araújo de Sousa 
3   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
,
Romilto Costa Pacheco Neto 
4   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Ribeirão Preto SP, Brazil.
,
Arthur de Oliveira Veras 
3   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
,
Camila Victória da Silva 
2   Centro Universitário UNINOVAFAPI, Departamento de Ciências da Saúde, Teresina PI, Brazil.
,
Cristina Calmon de Araújo Mascarenhas 
2   Centro Universitário UNINOVAFAPI, Departamento de Ciências da Saúde, Teresina PI, Brazil.
,
Matheus Felipe da Silva 
2   Centro Universitário UNINOVAFAPI, Departamento de Ciências da Saúde, Teresina PI, Brazil.
,
Gisele Sampaio Silva 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Octávio Marques Pontes-Neto 
3   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
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Abstract

Background

Prior to October 2022, stroke patients in Piaui lacked access to both stroke unit care and thrombolytic treatment, until the implementation of a telemedicine-based stroke care program.

Objective

To conduct a descriptive analysis of patients suspected of stroke who received telemedicine-based care in Piauí during the first year of the program's implementation.

Methods

We conducted a retrospective analysis of 868 patients treated from October 2022 to September 2023 under the state-wide stroke care program, which includes 6 Stroke Treatment Centers distributed around the state. Utilizing data from the JOIN telemedicine platform, the analysis focused on patient demographics, stroke types, treatment timelines, and outcomes of thrombolytic treatment.

Results

The cohort included 868 patients, with a mean age of 67.2 years, out of whom 55.5% were male. Chronic hypertension was reported in 57.8% and diabetes in 22.5% of the patients. The average onset-to-door time was 3.3 hours, door-to-computed tomography time was 23 minutes, and door-to-needle time averaged 67 minutes. Thrombolysis was administered to 15.6% of all stroke cases, with 31.8% among those being ischemic strokes. Among patients who arrived within the thrombolytic time window, the rate was 27.3%.

Conclusion

The introduction of a telemedicine-based stroke care program in Piauí has significantly enhanced access to essential stroke treatments, demonstrating its effectiveness in overcoming healthcare disparities. The initiative's success underscores the potential of telemedicine as a scalable model for improving stroke care in regions with limited healthcare resources. Future efforts will focus on reducing treatment times and expanding stroke care infrastructure to ensure comprehensive patient care.

Keywords

Stroke - Telemedicine - Thrombolytic Therapy - Healthcare Disparities - Brazil

Authors' Contributions

IFR, IAS: conceptualization, writing - original draft and writing - review & editing; RCPN, AOV: data curation and formal analysis; CVS, CCM, MFS: data curation; and GSS, OMPN: supervision. All authors approved the final version of the manuscript and agree to be responsible for all aspects of the work. IFR and IAS contributed as first authors of the manuscript.


Ethical Compliance

The study was approved by the Ethics Committee of Centro Universitário UNINOVAFAPI (approval number 6.569.830), with access to data granted by the State Health Department of Piauí (Secretaria de Estado da Saúde do Piauí, SESAPI, in Portuguese), ensuring full adherence to ethical standards. The requirement for a consent form was waived by the ethics committees, given that the data collection serves the purpose of monitoring care quality and aims to refine poststroke care recommendations. At no point are patients' personal data disclosed.


Editor-in-Chief: Ayrton Roberto Massaro 0000-0002-0487-5299.


Associate Editor: Marcos Christiano Lange 0000-0002-0405-7157.




Publikationsverlauf

Eingereicht: 28. Juli 2024

Angenommen: 13. Februar 2025

Artikel online veröffentlicht:
01. Juni 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Irapuá Ferreira Ricarte, Ícaro Araújo de Sousa, Romilto Costa Pacheco Neto, Arthur de Oliveira Veras, Camila Victória da Silva, Cristina Calmon de Araújo Mascarenhas, Matheus Felipe da Silva, Gisele Sampaio Silva, Octávio Marques Pontes-Neto. Telemedicine transforming stroke care in Piauí: an analysis of a state-wide initiative's first year. Arq Neuropsiquiatr 2025; 83: s00451807719.
DOI: 10.1055/s-0045-1807719
 

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