Do Elderly Patients Call 911 When Presented with Clinical Scenarios Suggestive of Acute Stroke? A Cross-Sectional Study
Do Elderly Patients Call 911 When Presented with Clinical Scenarios Suggestive of Acute Stroke? A Cross-Sectional Study
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DOI：
10.1159/000369962
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发表时间：
2015-01-01
影响因子：
2.9
通讯作者：
Martha Esnaola, Maria
中科院分区：
文献类型：
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作者：
Caruso, Diego;Perez Akly, Manuel;Martha Esnaola, Maria
背景和目的：在有急性卒中症状的患者中，入院延迟是使用溶栓治疗和其他干预措施的主要障碍，这些干预措施与死亡率和残疾率降低有关。本研究的主要目的是使用标准化问卷评估老年临床人群在出现卒中体征和症状时是否正确认可对紧急服务呼叫的响应。研究方法：我们在阿根廷布宜诺斯艾利斯的一家政府资助的健康诊所随机招募的老年门诊患者（>= 60岁）中进行了一项横断面研究。使用中风动作测试评估对拨打911的意图的正确认可，并将截止点设定为>= 75%。还收集了卒中知识和临床及社会人口统计学指标，并使用逻辑回归评估其作为正确认可的预测因素。结果：在367名老年人中，14%的人正确地赞同拨打911的意图。呈现最典型的体征和症状，只有65%的人报告说他们会叫救护车。短暂性黑蒙是被称为最少的症状（15%）。平均而言，只有37%的时间选择了正确的答案。与较低的教育水平相比，较高的教育水平与正确认可的拨打911的意图相关（中学调整的OR 3.53，95%CI 1.59-7.86，大专/大学调整的OR 3.04，95%CI 1.12-8.21）。结论：这些结果表明，需要提供专门设计的干预措施，以提高对潜在卒中体征和症状的认识，并采取适当的后续临床措施。(C)2015 S. Karger AG，巴塞尔
Background and Purpose: Among patients with acute stroke symptoms, delay in hospital admission is the main obstacle for the use of thrombolytic therapy and other interventions associated with decreased mortality and disability. The primary aim of this study was to assess whether an elderly clinical population correctly endorsed the response to call for emergency services when presented with signs and symptoms of stroke using a standardized questionnaire. Methods: We performed a cross-sectional study among elderly out-patients (>= 60 years) in Buenos Aires, Argentina randomly recruited from a government funded health clinic. The correct endorsement of intention to call 911 was assessed with the Stroke Action Test and the cut-off point was set at >= 75%. Knowledge of stroke and clinical and socio-de-mographic indicators were also collected and evaluated as predictors of correct endorsement using logistic regression. Results: Among 367 elderly adults, 14% correctly endorsed intention to call 911. Presented with the most typical signs and symptoms, only 65% reported that they would call an ambulance. Amaurosis Fugax was the symptom for which was called the least (15%). On average, the correct response was chosen only 37% of the time. Compared to lower levels of education, higher levels were associated to correctly endorsed intention to call 911 (secondary School adjusted OR 3.53, 95% CI 1.59-7.86 and Tertiary/University adjusted OR 3.04, 95% CI 1.12-8.21). Conclusions: These results suggest the need to provide interventions that are specifically designed to increase awareness of potential stroke signs and symptoms and appropriate subsequent clinical actions. (C) 2015 S. Karger AG, Basel