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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
Open this publication in new window or tab >>A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service
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2018 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 137, no 5, p. 523-530Article in journal (Refereed) 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.

Keywords
EMS, prehospital, stroke, system delay
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-12003 (URN)10.1111/ane.12895 (DOI)000429693800010 ()29315463 (PubMedID)2-s2.0-85040200414 (Scopus ID)
Funder
Region Västra Götaland
Note

First published online: 8 January 2018

Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2019-03-12Bibliographically approved
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.
Open this publication in new window or tab >>Prehospital identification of factors associated with death during one-year follow-up after acute stroke
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2018 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 8, no 6, article id e00987Article in journal (Refereed) 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.

Keywords
acute stroke, early chain, mortality, one-year follow-up
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-12337 (URN)10.1002/brb3.987 (DOI)000434409200019 ()29770601 (PubMedID)2-s2.0-85047512969 (Scopus ID)
Funder
Region Västra Götaland
Note

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)

Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2019-01-25Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6366-1856

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