Utilization of emergency medical service increases chance of thrombolytic therapy in patients with acute ischemic stroke

Ming Ju Hsieh, Sung Chun Tang, Wen Chu Chiang, Kuang Yu Huang, Anna Marie Chang, Patrick Chow In Ko, Li Kai Tsai, Jiann Shing Jeng, Matthew Huei Ming Ma

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 3hours 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.

Original languageEnglish (US)
Pages (from-to)813-819
Number of pages7
JournalJournal of the Formosan Medical Association
Volume113
Issue number11
DOIs
StatePublished - Nov 1 2014

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Thrombolytic Therapy
Emergency Medical Services
Hospital Emergency Service
Stroke
Needles
Odds Ratio
Confidence Intervals
Intravenous Administration
Registries

Keywords

  • Emergency medical services
  • Stroke
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Utilization of emergency medical service increases chance of thrombolytic therapy in patients with acute ischemic stroke. / Hsieh, Ming Ju; Tang, Sung Chun; Chiang, Wen Chu; Huang, Kuang Yu; Chang, Anna Marie; Ko, Patrick Chow In; Tsai, Li Kai; Jeng, Jiann Shing; Ma, Matthew Huei Ming.

In: Journal of the Formosan Medical Association, Vol. 113, No. 11, 01.11.2014, p. 813-819.

Research output: Contribution to journalArticle

Hsieh, Ming Ju ; Tang, Sung Chun ; Chiang, Wen Chu ; Huang, Kuang Yu ; Chang, Anna Marie ; Ko, Patrick Chow In ; Tsai, Li Kai ; Jeng, Jiann Shing ; Ma, Matthew Huei Ming. / Utilization of emergency medical service increases chance of thrombolytic therapy in patients with acute ischemic stroke. In: Journal of the Formosan Medical Association. 2014 ; Vol. 113, No. 11. pp. 813-819.
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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 3hours 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.",
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