Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Dokumenter
- Fulltext
Forlagets udgivne version, 657 KB, PDF-dokument
To investigate the association between the Emergency Medical Service dispatcher’s initial stroke triage and prehospital stroke management, primary admission to hospitals offering revascularization treatment, prehospital time delay, and rate of acute revascularization. In an observational cohort study, patients with acute ischemic stroke (AIS) in Denmark (2017–2018) were included if the emergency call to the Emergency Medical Dispatch Center (EMDC) was made within three hours after symptom onset. Among 3546 included AIS patients, the EMS dispatcher identified 74.6% (95% confidence interval (CI) 73.1–76.0) correctly as stroke. EMS dispatcher stroke recognition was associated with a higher rate of primary admission to a hospital offering revascularization treatment (85.8 versus 74.5%); producing an adjusted risk difference (RD) of 11.1% (95% CI 7.8; 14.3) and a higher rate of revascularization treatment (49.6 versus 41.6%) with an adjusted RD of 8.4% (95% CI 4.6; 12.2). We adjusted for sex, age, previous stroke or transient ischemic attack, and stroke severity. EMDC stroke recognition was associated with shorter prehospital delay. For all AIS patients, the adjusted difference was − 33.2 min (95% CI − 44.4; − 22.0). Among patients receiving acute revascularization treatment (n = 1687), the adjusted difference was -12.6 min (95% CI − 18.9; − 6.3). Stroke recognition by the EMS dispatcher was associated with a higher probability of primary admission to a hospital offering acute stroke treatment, and subsequently with a higher rate of acute revascularization treatment, and with an overall reduction in prehospital delay.
Originalsprog | Engelsk |
---|---|
Tidsskrift | Internal and Emergency Medicine |
Vol/bind | 18 |
Sider (fra-til) | 2355–2365 |
Antal sider | 11 |
ISSN | 1828-0447 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
Open access funding provided by Central Region of Denmark. The study was supported by a grant from the non-profit Danish foundation, TrygFonden (grant number 117615). The foundation did not influence the study, draft of manuscript or interpretation of results.
Publisher Copyright:
© 2023, The Author(s).
Antal downloads er baseret på statistik fra Google Scholar og www.ku.dk
ID: 367601167