PURPOSE Teleconsultation is a consultation between two or more physicians about the diagnostic work-up and therapeutic strategy in the treatment of an individual case by means of modern telematics. 'Drip-and-ship' teleconsultation model consists of the transfer of patients, through telematics stroke networks, with large arteries occlusions from primary to comprehensive stroke centers equipped for endovascular therapy. We retrospectively investigated appropriateness, safety, and effectiveness of 'drip-and-ship' teleconsultation model in a rural area of Tuscany. METHODS Outcome measures were: door-to-ship time (including door-to-needle time), ratio of number treated/total sent patients, adverse events/mortality during transfer, and mortality and modified Rankin scale at 90 days. Analysis of non-treated patients was also done. RESULTS Seventy-eight patients were included; 16/78 patients were sent for endovascular therapy alone, and 62/78 for "drip-and-ship"; 12 patients were not treated. Door-to-ship, and door-to-needle times (mean ± SD) were 105 ± 29.8 and 62.5 ± 37.5 min, respectively. The ratio number of treated/total sent patients was 0.85. At 90 days, the global mortality rate was 21%, and 40% of patients showed favorable outcome. The main cause of non-treatment was spontaneous recanalization. CONCLUSIONS The high value for treated/total sent patients' ratio underlines that "drip-and-ship" teleconsultation model is appropriate and effective, with a few untreated patients. The model is safe, without adverse events during transfer. Taken together, our outcomes are in line with the previous reports. "Drip-and-ship" teleconsultation model is safe and effective in rural areas, allowing good selections and rapid treatments for stroke patients, based on the transfer from the primary to the comprehensive stroke center.

中文翻译：

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托斯卡纳东南部“滴水运输”远程会诊模型的适当性，安全性和有效性：一项可行性研究。

目的远程咨询是两个或两个以上医生之间就现代远程信息处理治疗个别病例的诊断方法和治疗策略的咨询。“滴灌式”远程会诊模型包括通过远程信息处理卒中网络将患者转移，从主要卒中到大型卒中中心进行大动脉闭塞，以进行血管内治疗。我们回顾了托斯卡纳农村地区“滴水一船”远程咨询模型的适用性，安全性和有效性。方法结果指标为：上船时间（包括上门针时间），接受治疗的人数/总发送患者的比率，转移期间的不良事件/死亡率，以及90天时的死亡率和改良的兰金评分。还对未接受治疗的患者进行了分析。结果共纳入78例患者。16/78例患者仅接受血管内治疗，62/78例进行“滴灌”。12例患者未接受治疗。登船时间和登机时间（均值±标准差）分别为105±29.8和62.5±37.5分钟。接受治疗的患者/总发送患者的比例为0.85。在90天时，全球死亡率为21％，40％的患者显示出良好的预后。不治疗的主要原因是自发性再通。结论高治疗价值/总发送患者比率表明，“滴水运输”远程咨询模型是适当且有效的，有少数未经治疗的患者。该模型是安全的，在传输过程中没有不良事件。两者合计，我们的结果与以前的报告一致。“滴水运输”