TY - JOUR
T1 - Utilization of emergency medical service increases chance of thrombolytic therapy in patients with acute ischemic stroke
AU - Hsieh, Ming Ju
AU - Tang, Sung Chun
AU - Chiang, Wen Chu
AU - Huang, Kuang Yu
AU - Chang, Anna Marie
AU - Ko, Patrick Chow In
AU - Tsai, Li Kai
AU - Jeng, Jiann Shing
AU - Ma, Matthew Huei Ming
N1 - Funding Information:
The study was supported by grants from National Taiwan University Hospital ( 101-S1870 ) and National Science Council, Taiwan ( NSC1012314-B002-120MY3 ). Dr. Chang is supported by Award Number 1K12HL108974-01 from the National Heart, Lung, and Blood Institute.
Publisher Copyright:
© 2013 .
PY - 2014/11/1
Y1 - 2014/11/1
N2 - 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.
AB - 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.
KW - Emergency medical services
KW - Stroke
KW - Thrombolytic therapy
UR - http://www.scopus.com/inward/record.url?scp=84922009031&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922009031&partnerID=8YFLogxK
U2 - 10.1016/j.jfma.2013.10.020
DO - 10.1016/j.jfma.2013.10.020
M3 - Article
C2 - 24296308
AN - SCOPUS:84922009031
SN - 0929-6646
VL - 113
SP - 813
EP - 819
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 11
ER -