Influence of the stroke code activation source on the outcome of acute ischemic stroke patients.
Neurology
; 70(15): 1238-43, 2008 Apr 08.
Article
en En
| MEDLINE
| ID: mdl-18322264
ABSTRACT
INTRODUCTION:
In our metropolitan area, the Stroke Code (SC) system allows immediate transfer of patients with acute stroke to a stroke center. It may be activated by community hospitals (A), emergency medical services (EMS, B), or the emergency department of the stroke center (C). Our aim was to analyze whether the SC activation source influences the access to thrombolytic therapy and outcome of patients with ischemic stroke.METHODS:
We prospectively registered patients with ischemic stroke admitted to the acute stroke unit who arrived through the SC system. The primary outcome variable was good outcome at discharge (Rankin ScaleRESULTS:
A total of 262 consecutive patients with hyperacute ischemic stroke were studied; the SC source was A in 112, B in 57, and C in 92. Median time from onset to admission was longer in Group A and stroke severity higher in Groups B and C. Percentage of tPA administration was higher in patients from Groups B and C (27%, 54%, and 46% of patients; p = 0.001). With respect to Group A, Group B was associated with good outcome with an odds of 2.9 (1.2-6.6; p = 0.01), and Group C with an odds of 2.4 (1.1-4.9; p = 0.01) after adjustment for age and stroke severity at baseline. Patients coming via levels B and C were more likely to improve at 24 hours.CONCLUSIONS:
Patients arriving directly to the stroke center via emergency medical services or on their own receive neurologic attention sooner, are more frequently treated with tPA, and have better clinical outcome than those patients who are first taken to a community hospital.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Evaluación de Resultado en la Atención de Salud
/
Accidente Cerebrovascular
/
Sistemas de Comunicación entre Servicios de Urgencia
/
Servicios Médicos de Urgencia
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Servicio de Urgencia en Hospital
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
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Risk_factors_studies
/
Screening_studies
País/Región como asunto:
Europa
Idioma:
En
Revista:
Neurology
Año:
2008
Tipo del documento:
Article
País de afiliación:
España