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Andersson Hagiwara, M., Wireklint Sundström, B., Brink, P., Herlitz, J. & Hansson, P.-O. -. (2018). A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service. Acta Neurologica Scandinavica, 137(5), 523-530
Öppna denna publikation i ny flik eller fönster >>A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service
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2018 (Engelska)Ingår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 137, nr 5, s. 523-530Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. Materials & methods The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital. Results Of 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient’s decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital. Conclusions Patients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.

Nyckelord
EMS, prehospital, stroke, system delay
Nationell ämneskategori
Omvårdnad
Forskningsämne
VÅRD- OCH HÄLSOVETENSKAP, Vårdvetenskap
Identifikatorer
urn:nbn:se:hv:diva-12003 (URN)10.1111/ane.12895 (DOI)000429693800010 ()29315463 (PubMedID)2-s2.0-85040200414 (Scopus ID)
Forskningsfinansiär
Västra Götalandsregionen
Anmärkning

First published online: 8 January 2018

Tillgänglig från: 2018-01-15 Skapad: 2018-01-15 Senast uppdaterad: 2019-03-12Bibliografiskt granskad
Hansson, P.-O., Andersson Hagiwara, M., Brink, P., Herlitz, J. & Wireklint Sundström, B. (2018). Prehospital identification of factors associated with death during one-year follow-up after acute stroke. Brain and Behavior, 8(6), Article ID e00987.
Öppna denna publikation i ny flik eller fönster >>Prehospital identification of factors associated with death during one-year follow-up after acute stroke
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2018 (Engelska)Ingår i: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 8, nr 6, artikel-id e00987Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

ObjectivesIn acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke.Material and MethodsAll patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1.6 million inhabitants) during a four‐month period were included. There were no exclusion criteria.ResultsIn all, 1,028 patients with a confirmed diagnosis of stroke who used the EMS were included in the analyses. Among these patients, 360 (35%) died during the following year. Factors that were independently associated with an increased risk of death were as follows: (1) high age, per year OR 1.07; 95% CI 1.05‐1.09; (2) a history of heart failure, OR 2.08; 95% CI 1.26‐3.42; (3) an oxygen saturation of <90%, OR 8.05; 95% CI 3.33‐22.64; and (4) a decreased level of consciousness, OR 2.19; 95% CI 1.61‐3.03.ConclusionsAmong patients with a stroke, four factors identified before arrival at hospital were associated with a risk of death during the following year. They were reflected in the patients' age, previous clinical history, respiratory function, and the function of the central nervous system.

Nyckelord
acute stroke, early chain, mortality, one-year follow-up
Nationell ämneskategori
Omvårdnad
Forskningsämne
VÅRD- OCH HÄLSOVETENSKAP, Vårdvetenskap
Identifikatorer
urn:nbn:se:hv:diva-12337 (URN)10.1002/brb3.987 (DOI)000434409200019 ()29770601 (PubMedID)2-s2.0-85047512969 (Scopus ID)
Forskningsfinansiär
Västra Götalandsregionen
Anmärkning

First published: 16 May 2018

Funders: Swedish state under the agreement between the Swedish government and the county councils concerning economic support of research and education (ALF agreement)

Tillgänglig från: 2018-06-15 Skapad: 2018-06-15 Senast uppdaterad: 2019-01-25Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-6366-1856

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