Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program
Background The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) c...
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| Veröffentlicht in: | Journal of stroke and cerebrovascular diseases 2016-07, Vol.25 (7), p.1665-1670 |
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| creator | Kim, Dae-Hyun, MD Nah, Hyun-Wook, MD Park, Hyun-Seok, MD Choi, Jae-Hyung, MD Kang, Myong-Jin, MD Huh, Jae-Taeck, MD Cha, Jae-Kwan, MD |
| description | Background The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program. Methods Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke. We compared baseline characteristics and prehospital/in-hospital delay time in stroke patients treated with intravenous recombinant tissue plasminogen activator for 44 months with and without EMS use and/or PN. Results Intravenous thrombolytic therapy was performed on 274 patients. Of those patients, 215 (78.5%) were transported to the hospital via EMS and 59 (21.5%) were admitted via private modes of transportation. The patients who used EMS had shorter median onset-to-arrival times (62 minutes versus 116 minutes, P |
| doi_str_mv | 10.1016/j.jstrokecerebrovasdis.2016.02.011 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1797872453</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1052305716000975</els_id><sourcerecordid>1797872453</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-794779abce97e2067dd96298d7d2aca127ad5781d1f72f727654886a5468f8143</originalsourceid><addsrcrecordid>eNqVUt-L1DAQLqJ4P_RfkDyK0JqkTZO-CLrn6cKCwq3PIZtM3fTapibZld7b_eem7nkP4oswkEzmm--bzEyWvSG4IJjUb7uiC9G7W9DgYefdUQVjQ0FTrMC0wIQ8yc4JK2kuGCFP0x0zmpeY8bPsIoQOJwQT7Hl2RjmuuRD8PLtfD5PSEbkWffWwd2GyUfVoPUbwRxijdSNKdgW9mtHWDoCiQ9u9d8PO9XO0Ojng1TQjOyKFbn7Xh1aw5KOfNu6XxzlEGOwdmMe4M5D03HevhhfZs1b1AV4-nJfZt-uP29XnfPPl03r1fpPrijUx503FeaN2GhoONJVvTFPTRhhuqNKKUK4M44IY0nKajNesEqJWrKpFK0hVXmavT7yTdz8OEKIcbNDQ92oEdwiS8IYLTitWJuiHE1R7F4KHVk7eDsrPkmC5jEJ28l-jkMsoJKYyNTqRvHrQO-wGMI8Uf3qfAJsTANKvjxa8DNrCqMFYDzpK4-z_6b37i073drRa9bcwQ-jcwY-pv5LIkBLkzbIcy26QGmPccFb-AoXDvrk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1797872453</pqid></control><display><type>article</type><title>Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Kim, Dae-Hyun, MD ; Nah, Hyun-Wook, MD ; Park, Hyun-Seok, MD ; Choi, Jae-Hyung, MD ; Kang, Myong-Jin, MD ; Huh, Jae-Taeck, MD ; Cha, Jae-Kwan, MD</creator><creatorcontrib>Kim, Dae-Hyun, MD ; Nah, Hyun-Wook, MD ; Park, Hyun-Seok, MD ; Choi, Jae-Hyung, MD ; Kang, Myong-Jin, MD ; Huh, Jae-Taeck, MD ; Cha, Jae-Kwan, MD</creatorcontrib><description>Background The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program. Methods Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke. We compared baseline characteristics and prehospital/in-hospital delay time in stroke patients treated with intravenous recombinant tissue plasminogen activator for 44 months with and without EMS use and/or PN. Results Intravenous thrombolytic therapy was performed on 274 patients. Of those patients, 215 (78.5%) were transported to the hospital via EMS and 59 (21.5%) were admitted via private modes of transportation. The patients who used EMS had shorter median onset-to-arrival times (62 minutes versus 116 minutes, P < .001). There was no difference in in-hospital delay time between the 2 groups. In 28 cases (13%) of EMS transport, EMS personnel called the clinical staff to notify the incoming patient. Prenotification by EMS was associated with shorter median door-to-imaging time (9 minutes versus 12 minutes, P = .045) and door-to-needle time (20 minutes versus 29 minutes, P = .011). Conclusions We found that EMS use reduces prehospital delay time. However, EMS use without prenotification does not shorten in-hospital processing time in a stroke center with a systemized stroke code program.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.011</identifier><identifier>PMID: 27067887</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Ambulances ; Cardiovascular ; Cell Phone ; Delivery of Health Care, Integrated ; door-to-needle time ; Emergency Medical Services ; emergency medicine ; Female ; Fibrinolytic Agents - administration & dosage ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Neurology ; Patient Care Team ; prenotification ; Program Evaluation ; Recombinant Proteins - administration & dosage ; Republic of Korea ; Retrospective Studies ; Stroke ; Stroke - diagnosis ; Stroke - drug therapy ; Stroke - physiopathology ; thrombolysis ; Thrombolytic Therapy ; Time Factors ; Time-to-Treatment ; Tissue Plasminogen Activator - administration & dosage ; Treatment Outcome</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2016-07, Vol.25 (7), p.1665-1670</ispartof><rights>2016</rights><rights>Copyright © 2016. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-794779abce97e2067dd96298d7d2aca127ad5781d1f72f727654886a5468f8143</citedby><cites>FETCH-LOGICAL-c459t-794779abce97e2067dd96298d7d2aca127ad5781d1f72f727654886a5468f8143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27067887$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Dae-Hyun, MD</creatorcontrib><creatorcontrib>Nah, Hyun-Wook, MD</creatorcontrib><creatorcontrib>Park, Hyun-Seok, MD</creatorcontrib><creatorcontrib>Choi, Jae-Hyung, MD</creatorcontrib><creatorcontrib>Kang, Myong-Jin, MD</creatorcontrib><creatorcontrib>Huh, Jae-Taeck, MD</creatorcontrib><creatorcontrib>Cha, Jae-Kwan, MD</creatorcontrib><title>Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>Background The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program. Methods Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke. We compared baseline characteristics and prehospital/in-hospital delay time in stroke patients treated with intravenous recombinant tissue plasminogen activator for 44 months with and without EMS use and/or PN. Results Intravenous thrombolytic therapy was performed on 274 patients. Of those patients, 215 (78.5%) were transported to the hospital via EMS and 59 (21.5%) were admitted via private modes of transportation. The patients who used EMS had shorter median onset-to-arrival times (62 minutes versus 116 minutes, P < .001). There was no difference in in-hospital delay time between the 2 groups. In 28 cases (13%) of EMS transport, EMS personnel called the clinical staff to notify the incoming patient. Prenotification by EMS was associated with shorter median door-to-imaging time (9 minutes versus 12 minutes, P = .045) and door-to-needle time (20 minutes versus 29 minutes, P = .011). Conclusions We found that EMS use reduces prehospital delay time. However, EMS use without prenotification does not shorten in-hospital processing time in a stroke center with a systemized stroke code program.</description><subject>Aged</subject><subject>Ambulances</subject><subject>Cardiovascular</subject><subject>Cell Phone</subject><subject>Delivery of Health Care, Integrated</subject><subject>door-to-needle time</subject><subject>Emergency Medical Services</subject><subject>emergency medicine</subject><subject>Female</subject><subject>Fibrinolytic Agents - administration & dosage</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Patient Care Team</subject><subject>prenotification</subject><subject>Program Evaluation</subject><subject>Recombinant Proteins - administration & dosage</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>Stroke</subject><subject>Stroke - diagnosis</subject><subject>Stroke - drug therapy</subject><subject>Stroke - physiopathology</subject><subject>thrombolysis</subject><subject>Thrombolytic Therapy</subject><subject>Time Factors</subject><subject>Time-to-Treatment</subject><subject>Tissue Plasminogen Activator - administration & dosage</subject><subject>Treatment Outcome</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVUt-L1DAQLqJ4P_RfkDyK0JqkTZO-CLrn6cKCwq3PIZtM3fTapibZld7b_eem7nkP4oswkEzmm--bzEyWvSG4IJjUb7uiC9G7W9DgYefdUQVjQ0FTrMC0wIQ8yc4JK2kuGCFP0x0zmpeY8bPsIoQOJwQT7Hl2RjmuuRD8PLtfD5PSEbkWffWwd2GyUfVoPUbwRxijdSNKdgW9mtHWDoCiQ9u9d8PO9XO0Ojng1TQjOyKFbn7Xh1aw5KOfNu6XxzlEGOwdmMe4M5D03HevhhfZs1b1AV4-nJfZt-uP29XnfPPl03r1fpPrijUx503FeaN2GhoONJVvTFPTRhhuqNKKUK4M44IY0nKajNesEqJWrKpFK0hVXmavT7yTdz8OEKIcbNDQ92oEdwiS8IYLTitWJuiHE1R7F4KHVk7eDsrPkmC5jEJ28l-jkMsoJKYyNTqRvHrQO-wGMI8Uf3qfAJsTANKvjxa8DNrCqMFYDzpK4-z_6b37i073drRa9bcwQ-jcwY-pv5LIkBLkzbIcy26QGmPccFb-AoXDvrk</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Kim, Dae-Hyun, MD</creator><creator>Nah, Hyun-Wook, MD</creator><creator>Park, Hyun-Seok, MD</creator><creator>Choi, Jae-Hyung, MD</creator><creator>Kang, Myong-Jin, MD</creator><creator>Huh, Jae-Taeck, MD</creator><creator>Cha, Jae-Kwan, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160701</creationdate><title>Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program</title><author>Kim, Dae-Hyun, MD ; Nah, Hyun-Wook, MD ; Park, Hyun-Seok, MD ; Choi, Jae-Hyung, MD ; Kang, Myong-Jin, MD ; Huh, Jae-Taeck, MD ; Cha, Jae-Kwan, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-794779abce97e2067dd96298d7d2aca127ad5781d1f72f727654886a5468f8143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Ambulances</topic><topic>Cardiovascular</topic><topic>Cell Phone</topic><topic>Delivery of Health Care, Integrated</topic><topic>door-to-needle time</topic><topic>Emergency Medical Services</topic><topic>emergency medicine</topic><topic>Female</topic><topic>Fibrinolytic Agents - administration & dosage</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Patient Care Team</topic><topic>prenotification</topic><topic>Program Evaluation</topic><topic>Recombinant Proteins - administration & dosage</topic><topic>Republic of Korea</topic><topic>Retrospective Studies</topic><topic>Stroke</topic><topic>Stroke - diagnosis</topic><topic>Stroke - drug therapy</topic><topic>Stroke - physiopathology</topic><topic>thrombolysis</topic><topic>Thrombolytic Therapy</topic><topic>Time Factors</topic><topic>Time-to-Treatment</topic><topic>Tissue Plasminogen Activator - administration & dosage</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Dae-Hyun, MD</creatorcontrib><creatorcontrib>Nah, Hyun-Wook, MD</creatorcontrib><creatorcontrib>Park, Hyun-Seok, MD</creatorcontrib><creatorcontrib>Choi, Jae-Hyung, MD</creatorcontrib><creatorcontrib>Kang, Myong-Jin, MD</creatorcontrib><creatorcontrib>Huh, Jae-Taeck, MD</creatorcontrib><creatorcontrib>Cha, Jae-Kwan, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of stroke and cerebrovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Dae-Hyun, MD</au><au>Nah, Hyun-Wook, MD</au><au>Park, Hyun-Seok, MD</au><au>Choi, Jae-Hyung, MD</au><au>Kang, Myong-Jin, MD</au><au>Huh, Jae-Taeck, MD</au><au>Cha, Jae-Kwan, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program</atitle><jtitle>Journal of stroke and cerebrovascular diseases</jtitle><addtitle>J Stroke Cerebrovasc Dis</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>25</volume><issue>7</issue><spage>1665</spage><epage>1670</epage><pages>1665-1670</pages><issn>1052-3057</issn><eissn>1532-8511</eissn><abstract>Background The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program. Methods Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke. We compared baseline characteristics and prehospital/in-hospital delay time in stroke patients treated with intravenous recombinant tissue plasminogen activator for 44 months with and without EMS use and/or PN. Results Intravenous thrombolytic therapy was performed on 274 patients. Of those patients, 215 (78.5%) were transported to the hospital via EMS and 59 (21.5%) were admitted via private modes of transportation. The patients who used EMS had shorter median onset-to-arrival times (62 minutes versus 116 minutes, P < .001). There was no difference in in-hospital delay time between the 2 groups. In 28 cases (13%) of EMS transport, EMS personnel called the clinical staff to notify the incoming patient. Prenotification by EMS was associated with shorter median door-to-imaging time (9 minutes versus 12 minutes, P = .045) and door-to-needle time (20 minutes versus 29 minutes, P = .011). Conclusions We found that EMS use reduces prehospital delay time. However, EMS use without prenotification does not shorten in-hospital processing time in a stroke center with a systemized stroke code program.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27067887</pmid><doi>10.1016/j.jstrokecerebrovasdis.2016.02.011</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Ambulances Cardiovascular Cell Phone Delivery of Health Care, Integrated door-to-needle time Emergency Medical Services emergency medicine Female Fibrinolytic Agents - administration & dosage Humans Infusions, Intravenous Male Middle Aged Neurology Patient Care Team prenotification Program Evaluation Recombinant Proteins - administration & dosage Republic of Korea Retrospective Studies Stroke Stroke - diagnosis Stroke - drug therapy Stroke - physiopathology thrombolysis Thrombolytic Therapy Time Factors Time-to-Treatment Tissue Plasminogen Activator - administration & dosage Treatment Outcome |
| title | Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program |
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