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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Hospital prenotification of stroke patients by emergency medical services improves stroke time targets
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Hospital prenotification of stroke patients by emergency medical services improves stroke time targets

机译：通过紧急医疗服务对中风患者进行医院预先通知可以改善中风时间目标

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Background: Prenotification to hospitals by emergency medical services of patients with suspected stroke is recommended to reduce delays in time-dependent therapies. We hypothesized that hospital prenotification would reduce recommended stroke time targets. Methods: We used the Robert Wood Johnson University Hospital (RWJUH) Brain Attack Database, which includes demographic and clinical data on all emergency department (ED) patients alerted as a Brain Attack between January 1, 2009 and June 30, 2010. Outcome variables included the time from door to stroke team arrival, computed tomographic (CT) scan completion, CT scan interpretation, electrocardiogram, laboratory results, treatment decision, and intravenous (IV) tissue plasminogen activator (tPA) administration. The primary independent variable was brain attack activation before arrival to the emergency department (ED; prenotification) versus on or after ED arrival (no prenotification). Analysis of covariance was used with patient predictors as covariates in addition to the one of interest (prenotification vs no prenotification). P ≤.05 was considered statistically significant. Results: There were 229 patients (114 prenotification and 115 no prenotification) alerted as having a brain attack within the study period. Patients with prehospital notification were older (69.5 years vs 61.5 years; P =.0002), had more severe strokes (National Institutes of Health Stroke Scale score of 11.1 vs 6.9; P <.0001), and received IV tPA twice as often (27% vs 15%; P =.024). Prenotification resulted in a significant reduction in all stroke time targets except door to treatment decision and tPA administration. Conclusions: Prehospital notification of suspected stroke patients reduces time to stroke team arrival, CT scan completion, and CT scan interpretation. IV thrombolysis occurred twice as often in the prenotification group.
机译：背景：建议对怀疑中风的患者进行紧急医疗服务，以预先通知医院，以减少时间依赖性疗法的延误。我们假设医院预先通知会减少推荐的卒中时间目标。方法：我们使用了罗伯特·伍德·约翰逊大学医院（RWJUH）脑部攻击数据库，该数据库包括2009年1月1日至2010年6月30日期间因脑部攻击而受到警报的所有急诊科（ED）患者的人口统计和临床数据。结果变量包括从门到中风团队到达的时间，计算机断层扫描（CT）扫描完成，CT扫描解释，心电图，实验室结果，治疗决定以及静脉内（IV）组织纤溶酶原激活剂（tPA）管理。主要的自变量是到达急诊室之前（ED;预先通知）与到达ED之后或之后（没有预先通知）的大脑发作激活。协方差分析与患者预测变量一起用作感兴趣变量之一（预通知与无预通知）。 P≤.05被认为具有统计学意义。结果：在研究期间，有229名患者（有114种预先通知和115种没有预先通知）被警告患有脑部发作。院前通知的患者年龄较大（69.5岁vs 61.5岁; P = .0002），患有更严重的中风（美国国立卫生研究院卒中量表评分为11.1 vs 6.9; P <.0001），并且两次接受静脉tPA的频率（ 27％和15％; P = .024）。预先通知导致所有卒中时间目标的显着减少，除了可以做出治疗决定和tPA管理的门。结论：疑似中风患者的院前通知减少了中风团队到达，CT扫描完成和CT扫描解释的时间。在预先通知组中，静脉溶栓发生的频率是其两倍。

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