Analysis on the application of emergency medical service in acute stroke treatment in Hebei Province
10.3760/cma.j.issn.1671-0282.2019.11.005
- VernacularTitle: 河北省急救医疗服务在脑卒中救治中应用情况的现状分析
- Author:
Yanling DONG
1
;
Xiaosen HAN
2
;
Yingsen HUANG
3
;
Haiying WU
4
;
Hengbo GAO
1
;
Dongqi YAO
1
;
Tuokang ZHENG
1
;
Hao XIAO
1
;
Qingbing MENG
1
;
Xiaolei CUI
1
;
Yingping TIAN
1
Author Information
1. Emergency Department, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
2. Emergency Department, Handan Central Hospital, Handan 056001, China
3. Emergency Department, The People’s Hospital of Langfang City, Langfang 065000, China
4. Emergency Department, TangShanGongRen Hospital, Tangshan 063000, China
- Publication Type:Journal Article
- Keywords:
Emergency medical services;
Stroke;
Therapy;
Prognosis;
Hebei Province
- From:
Chinese Journal of Emergency Medicine
2019;28(11):1357-1363
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application of emergency medical service (EMS) of Hebei Province and preliminarily analyze its value in the treatment of acute stroke patients.
Methods:We collected data of 4 147 acute stroke patients admitted to the Emergency Department between January 2016 and December 2016 in 49 hospitals of Hebei Province. Patients were divided into the EMS group and non-EMS group according to the pattern of arriving hospital. The general data, the onset-to-door time, door-to-treatment time, thrombolytic rate, length of hospital stay and prognosis were compared between the two groups. LSD-t test, Mann-Whitney U or Chi-squared test or Fisher exact test was used for statistical analysis as appropriate.
Results:A total of 4 147 acute stroke patients were enrolled, including 589 patients (14.2%) with hemorrhagic stroke and 3 558 patients (85.8%) with ischemic stroke. A total of 750 patients (18.1%) were admitted to the hospital by EMS. The proportion of patients with hemorrhagic stroke who used EMS was higher than that of ischemic stroke (33.4% vs 15.5%, P<0.01). The median onset-to-foor time in the EMS group was less than that in the non-EMS group (1.75 h vs 4.57 h, P<0.01). The median time of onset-to-door time within 1 h in the EMS group was longer than that of the non-EMS group (0.67 h vs 0.53 h, P<0.01). There was no significant difference between the two groups in 1-<2 h period and 2-<3 h period. The median time of onset-to-door time of ≥3 h in the EMS group was shorter than that of the non-EMS group (5.0 h vs 9.47 h, P<0.01). In the EMS group, the proportion of patients with onset-to-door time <3 h was higher than that of the non-EMS group (66.13% vs 57.44%, P<0.01). Compared with the non-EMS group, the time of door-to-treatment time was much shorter in the EMS group (87 min vs 101 min, P<0.01). The length of hospital stay in the EMS group was shorter than that of the non-EMS group [11 (7,14) days vs 12 (6,16) days, P<0.01]. In the EMS group, 15.9% patients received thrombolytic therapy, whereas only 11.0% patients in the non-EMS group received this therapy (P=0.001). In the EMS group, 88.8% patients achieved more favorable outcomes at discharge, which was higher than that in the non-EMS group (85.5%, P=0.02).
Conclusions:EMS is considered as effective in shortening onset-to-door time, reducing door-to-treatment time, improving thrombolytic rate, reducing hospitalization days, and enhancing the prognosis of acute stroke patients.
