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  • 1.
    Andersson Hagiwara, Magnus
    et al.
    University of Borås, PreHospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Wireklint Sundström, B.
    University of Borås, PreHospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Brink, Peter
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Herlitz, J.
    University of Borås, PreHospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Hansson, P. -O
    University of Gothenburg, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service2018In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 137, no 5, p. 523-530Article in journal (Refereed)
    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.

  • 2.
    Hansson, Per-Olof
    et al.
    University of Gothenburg, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Andersson Hagiwara, Magnus
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Centre for Prehospital Research, Borås, Sweden.
    Brink, Peter
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Centre for Prehospital Research, Borås, Sweden.
    Wireklint Sundström, Birgitta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Centre for Prehospital Research, Borås, Sweden.
    Prehospital identification of factors associated with death during one-year follow-up after acute stroke2018In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 8, no 6, article id e00987Article in journal (Refereed)
    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.

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