Stroke symptoms and the decision to call for an ambulance
Stroke symptoms and the decision to call for an ambulance
复制标题
DOI：
10.1161/01.str.0000254528.17405.cc
复制
发表时间：
2007-02-01
期刊：
影响因子：
8.3
通讯作者：
Dewey, Helen
中科院分区：
文献类型：
--
作者：
Mosley, Ian;Nicol, Marcus;Dewey, Helen
背景和目的：很少有急性卒中患者使用阿尔替普酶治疗，部分原因是症状出现后显著的院前延迟。这项研究的目的是在救护车运送的中风患者中确定与中风识别相关的因素，以及在症状出现后1小时内呼叫救护车援助的相关因素。方法：在2004年的6个月中，对所有从澳大利亚墨尔本地理区域到达3个医院急诊科之一的救护车运送的中风或短暂性脑缺血发作患者进行了评估。对救护车呼叫的录音进行了分析，并对患者和打电话的人进行了采访。结果：198名患者纳入研究。据报道，在44%的救护车呼叫中，中风是问题。非提示中风识别与面部下垂(P=0.015)和中风或短暂性脑缺血发作病史(P<；0.001)独立相关。超过一半的救护车求助电话是在症状出现后1小时内拨打的，这些呼叫者中只有43%的人自发地将问题确定为“中风”。与1小时内来电独立相关的因素有：言语问题(P=0.009)，来电者中风家族史(P=0.017)，以及患者在出现症状时并非孤军奋战(P=0.018)。结论--50%的来电者报告中风是(不提示的)问题。不到一半的电话是在症状出现后1小时内拨打的。需要采取干预措施，以更有力地将中风识别与立即行动联系起来，并增加符合急性治疗条件的中风患者的数量。(笔划。2007；38：361-366。)
Background and Purpose-Few acute stroke patients are treated with alteplase, partly because of significant prehospital delays after symptom onset. The aim of this study was to determine among ambulance-transported stroke patients factors associated with stroke recognition and factors associated with a call for ambulance assistance within 1 hour from symptom onset. Methods-For 6 months in 2004, all ambulance-transported stroke or transient ischemic attack patients arriving from a geographically defined region in Melbourne (Australia) to 1 of 3 hospital emergency departments were assessed. Tapes of the call for ambulance assistance were analyzed and the patient and the caller were interviewed. Results-One hundred ninety-eight patients were included in the study. Stroke was reported as the problem in 44% of ambulance calls. Unprompted stroke recognition was independently associated with facial droop (P=0.015) and a history of stroke or transient ischemic attack (P < 0.001). More than half of the calls for ambulance assistance were made within 1 hour from symptom onset and only 43% of these callers spontaneously identified the problem as "stroke." Factors independently associated with a call within 1 hour were: speech problems (P=0.009), caller family history of stroke (P=0.017), and the patient was not alone at symptom onset (P=0.018). Conclusions-Stroke was reported as the problem (unprompted) by < 50% of callers. Fewer than half the calls were made within 1 hour from symptom onset. Interventions are needed to more strongly link stroke recognition to immediate action and increase the number of stroke patients eligible for acute treatment. (Stroke. 2007;38:361-366.)