Ming-Ju Hsieh1, Sung-Chun Tang2, Wen-Chu Chiang1, Kuang-Yu Huang2, Anna Marie Chang3, Patrick Chow-In Ko1, Li-Kai Tsai2, Jiann-Shing Jeng4, Matthew Huei-Ming Ma5. 1. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan. 2. Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. 3. Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, USA. 4. Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: jsjeng@ntu.edu.tw. 5. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: matthew@ntu.edu.tw.
Abstract
BACKGROUND/ PURPOSE: To determine whether utilization of emergency medical service (EMS) can increase use and expedite delivery of the thrombolytic therapy in acute ischemic stroke patients. METHODS: We analyzed consecutive patients presenting to the emergency department (ED) with an ischemic stroke within 72 hours of symptom onset from a prospective stroke registry. Variables associated with early ED arrival (within 3 hours of stroke onset) and administration of intravenous thrombolytic therapy were analyzed. RESULTS: From January 1, 2010 to July 31, 2011, there were 1081 patients (62.3% men, age 69.6 ± 13 years) included in this study. Among them, 289 (26.7%) arrived in the ED within 3 hours, and 88 (8.1%) received thrombolytic therapy. Patients who arrived at the ED by EMS (n = 279, 25.8%) were independently associated with earlier ED arrival (adjusted odds ratio = 3.68, 95% confidence interval = 2.54-5.33), and higher chance of receiving thrombolytic therapy (adjusted odds ratio = 3.89, 95% confidence interval = 1.86-8.17). Furthermore, utilization of EMS significantly decreased onset-to-needle time by 26 minutes in patients receiving thrombolytic therapy. CONCLUSION: Utilization of EMS can not only help acute ischemic stroke patients in early presentation to ED, but also effectively facilitate thrombolytic therapy and shorten the onset-to-needle time.
BACKGROUND/ PURPOSE: To determine whether utilization of emergency medical service (EMS) can increase use and expedite delivery of the thrombolytic therapy in acute ischemic strokepatients. METHODS: We analyzed consecutive patients presenting to the emergency department (ED) with an ischemic stroke within 72 hours of symptom onset from a prospective stroke registry. Variables associated with early ED arrival (within 3 hours of stroke onset) and administration of intravenous thrombolytic therapy were analyzed. RESULTS: From January 1, 2010 to July 31, 2011, there were 1081 patients (62.3% men, age 69.6 ± 13 years) included in this study. Among them, 289 (26.7%) arrived in the ED within 3 hours, and 88 (8.1%) received thrombolytic therapy. Patients who arrived at the ED by EMS (n = 279, 25.8%) were independently associated with earlier ED arrival (adjusted odds ratio = 3.68, 95% confidence interval = 2.54-5.33), and higher chance of receiving thrombolytic therapy (adjusted odds ratio = 3.89, 95% confidence interval = 1.86-8.17). Furthermore, utilization of EMS significantly decreased onset-to-needle time by 26 minutes in patients receiving thrombolytic therapy. CONCLUSION: Utilization of EMS can not only help acute ischemic strokepatients in early presentation to ED, but also effectively facilitate thrombolytic therapy and shorten the onset-to-needle time.
Authors: Dawn Kleindorfer; Christopher J Lindsell; Charles J Moomaw; Kathleen Alwell; Daniel Woo; Matthew L Flaherty; Opeolu Adeoye; Tarek Zakaria; Joseph P Broderick; Brett M Kissela Journal: Am J Emerg Med Date: 2010-01-28 Impact factor: 2.469
Authors: Gregg C Fonarow; Eric E Smith; Jeffrey L Saver; Mathew J Reeves; Deepak L Bhatt; Maria V Grau-Sepulveda; DaiWai M Olson; Adrian F Hernandez; Eric D Peterson; Lee H Schwamm Journal: Circulation Date: 2011-02-10 Impact factor: 29.690
Authors: Werner Hacke; Geoffrey Donnan; Cesare Fieschi; Markku Kaste; Rüdiger von Kummer; Joseph P Broderick; Thomas Brott; Michael Frankel; James C Grotta; E Clarke Haley; Thomas Kwiatkowski; Steven R Levine; Chris Lewandowski; Mei Lu; Patrick Lyden; John R Marler; Suresh Patel; Barbara C Tilley; Gregory Albers; Erich Bluhmki; Manfred Wilhelm; Scott Hamilton Journal: Lancet Date: 2004-03-06 Impact factor: 79.321
Authors: Hanzhang Xu; Ying Xian; Fung Peng Woon; Janet Prvu Bettger; Daniel T Laskowitz; Yih Yng Ng; Marcus Eng Hock Ong; David Bruce Matchar; Deidre Anne De Silva Journal: Stroke Vasc Neurol Date: 2020-04-08