Impact of ambulance transport on the prognosis of thrombolytic therapy in patients with acute ischemic stroke
10.3760/cma.j.issn.1671-0282.2023.11.011
- VernacularTitle:救护车转运对急性缺血性脑卒中患者溶栓治疗预后的影响
- Author:
Chen LIU
1
;
Guofang JING
;
Ning WANG
;
Kun YAN
;
Shandong XIN
;
Anmu XIE
;
Binghui HOU
Author Information
1. 青岛市急救中心，青岛 266000
- Keywords:
ambulance transport;
Acute ischemic stroke;
Intravenous thrombolysis;
Emergency medical service
- From:
Chinese Journal of Emergency Medicine
2023;32(11):1490-1495
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Intravenous thrombolysis (IVT) in patients with acute ischemic stroke is strongly time-dependent.The purpose of this study was to investigate whether the transfer of ischemic stroke patients to hospital through emergency medical service (EMS) could shorten onset to needle time (ONT),onset to door time (ODT), door to imaging time(DIT), door to needle time(DNT) and improve the clinical outcomes of intravenous thrombolysis patients.Methods:We retrospectively collected the clinical and time data of acute ischemic stroke(AIS) patients who received IVT in the Affiliated Hospital of Qingdao University on Laoshan campus from September 2021 to August 2022 were retrospectively collected. Patients were divided into EMS group and Non-EMS group according to patients whether transferred by ambulance. The baseline characteristics, length of each period and differences in clinical outcome were compared. Good prognosis was defined as modified Rankin Scale score of 0-2 at 3-months.Results:A total of 175 patients aged (66.1 ±12.3) years were selected, including 63 females (36.0%) and 53 patients (30.3%) were transferred by EMS. Compared with the Non-EMS group, the patients in the EMS group were older, the baseline NIHSS score was higher, ODT and ONT were shorter (all P< 0.05), but there were no significant difference in DIT and DNT between the two groups. Binary Logistic regression model showed that after adjusting for age, sex, baseline NIHSS score, bridging therapy, history of atrial fibrillation, history of hypertension, the number of previous diseases and intracranial hemorrhage, EMS was independently associated with good prognosis of patients with acute ischemic stroke [odds ratio ( OR) 0.376, 95% confidence interval ( CI) 0.144~0.890, P=0.027). Conclusion:EMS could improve the clinical outcomes of acute stroke patients by shortening the ODT and ONT in patients with acute ischemic stroke.
