London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 701 670 Acute stroke: clinical patterns and practice Patterns of activity and reliability of an acute stroke telemedicine service – Dublin MidLein-ster Stroke Network Partnership J. Soh1, C. Offiah2, T. Coughlan3, P. O’Brien4, D.J.H. McCabe5, S. Murphy6, J. McManus7, D. O’Neill8, D.R. Collins9 Adelaide and Meath Hospital, Tallaght, Dublin, IRELAND1, Adelaide and Meath Hospital, Ire-land, Dublin, IRELAND2, Adelaide and Meath Hospital, Tallaght, Dublin, IRELAND3, Adelaide and Meath Hospital, Tallaght, Dublin, IRELAND4, Adelaide and Meath Hospital, Tallaght, Dublin, IRELAND5, mater misericordiae hospital, Dublin, IRELAND6, Midland Regional Hospital Tullam-ore, Dublin, IRELAND7, Adelaide and Meath Hospital, Tallaght, Dublin, IRELAND8, Adelaide and Meath Hospital, Tallaght, Dublin, IRELAND9 Introduction: Telemedicine can facilitate acute ischemic stroke treatment by immediate stroke-expert consultation particularly ‘out of hours’.The Dublin MidLeinster (DML) Stroke Network Partnership initiated a new telemedicine service (RP-7 InTouch Health) in 2010 with the aim of improving the delivery of acute stroke thrombolysis across a network of 3 regional stroke centres serving 760,000 people. Methods: Clinical data was prospectively collected by on-line consultation entry (Stroke Respond –InTouch Health) for 157 consecutive patients who were assessed for acute thrombolysis using the telemedi-cine system across 3 acute hospitals.Data regarding reliability of system and acceptability to patient/ carer was also recorded by a post-consultation on-line proforma. Results: 157 fully completed telemedicine consultations using the RP-7 system were analysed.Average age 65.94 (range 19-91) with a female:male ratio of 1:1.Average time between symptoms onset and pre-sentation to ED was 107 minutes (0-515 minutes).90.4% of patients presented to ED out of normal working hours,including weekends (n=141).Of the 85 (54.5%) presenting on weekdays,only 15 pre-sented during working hours (9am to 5pm).49.7% of all patients assessed were thrombolysed( n=78 ).Main reasons for not thrombolysing were:minor deficits (34.3%),non stroke diagnosis (15.7%),out-side thrombolysis window (11.4%).A post-consultation reliability proforma was completed in 107 cases.Successful log-in was achieved in all cases bar one (99.1%).Some difficulty logging in was re-ported in 5.6 % and 22.4% reported loss of signal during consultations.100% patients/carers agreed that the telemedicine was an acceptable form of consultation and all bar one reported that the con-sulting physician was easily understood and seen. Conclusion: Telemedicine assessments within the DML stroke network partnership were service associated with high rates of positive thrombolysis treatment decisions.The RP-7 system was very reliable regarding log- in.Some signal loss was reported in 1 in 5 consultations but did not interfere with completion of consultation. All patients/carers found the system acceptable and clear. 671 Acute stroke: clinical patterns and practice CORTISOLEMIA AND ANXIETY IN ACUTE PHASE OF ISCHEMIC STROKE: IS THERE A RELATIONSHIP ? O.C. Ibrahimagić1, D. Smajlović2, Z. Dostović3, A. Čičkušić4 Department of Neurology, University Clinical Centre Tuzla, Tuzla, BOSNIA-HERZE-GOVINA1, Department of Neurology, University Clinical Centre Tuzla, Tuzla, BOSNIA-HER-ZEGOVINA2, Department of Neurology, University Clinical Centre Tuzla, Tuzla, BOS-NIA- HERZEGOVINA3, Department of Radiology, University Clinical Centre Tuzla, Tuzla, BOSNIA-HERZEGOVINA4 Background: To evaluate cortisolemia and anxiety in patients within 48 hours (acute phase) of isch-emic stroke (IS) and analyze them in order to gender. Patients and methods: It was analyzed a sample of 40 patients (20 women and 20 men), with a mean age of 65.3 +/- 10.3 years. IS was confirmed by CT scan. We used flourometric method with DEL-FIA Cortisol immunoassay for measured levels of cortisol (normal range is 210-681 nmol/l). Anx-iety levels were measured with Zung scale (self estimated scale with 20 questions). Score 50 and higher was verification of anxiety. Results: Mean value of cortisol in acute phase of IS was 560.9 +/- 318.9 nmol/l. Hypercortisolemia was verified in 13 (32%) patients. Women had higher levels, but significant gender differences (fe-male vs. male) were not noted (621 +/-316.42 vs. 500.8 +/- 317.88) (p=0.238). Nine women (45%) and 4 men (20%) had hypercortisolemia (p=0.06). Mean value on Zung’s scale in acute phase of IS was 44.4 +/- 8.8. Anxiety was verified in 12 (30%) patients. Women had significantly higher mean levels on Zung’s scale (47.75 +/- 8.4 vs. 41.05 +/- 7.9) (p=0.013). Anxiety was registered in 9 (45%) female and 3 (15%) male patients (p=0.024). Cortisolemia and anxiety correlate in acute phase of IS (Pearson’s r =0.34), especially in women (Pearson’s r =0.43). There is no correlation between corti-solemia and levels of anxiety in men (Pearson’s r =0.16). Conclusion: In the acute phase of ischemic stroke hypercortisolemia and anxiety are present in one third of the patients, significantly more in women.
Karger_ESC London_2013
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