A comprehensive review of prehospital and in-hospital delay times in acute stroke care.
A comprehensive review of prehospital and in-hospital delay times in acute stroke care.
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DOI：
10.1111/j.1747-4949.2009.00276.x
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发表时间：
2009-06
期刊：
影响因子：
--
通讯作者：
Rosamond WD
中科院分区：
文献类型：
--
作者：
Evenson KR;Foraker RE;Morris DL;Rosamond WD
本研究的目的是系统地回顾和总结院前和院内卒中评估和治疗延迟时间。我们确定了123篇从1981年到2007年发表的独特的同行评议研究，这些研究是关于卒中、短暂性脑缺血发作或卒中样症状患者的院前和院内延迟时间的评估和治疗。基于对65个不同人群的研究，加权泊松回归表明，从症状发作到急诊科（艾德）到达，院前延迟的小时数/年每年下降6.0%（p<0.001）。对于住院延迟，加权泊松回归模型表明从艾德到达至艾德评价的延迟时间无有意义的变化（3.1%，p=0.49，基于12个人群组）。从艾德到达到神经学评价或通知的小时/年每年下降10.2%（基于16个人群组，p=0.23），从艾德到达到开始计算机断层扫描的延迟时间的小时/年每年下降10.7%（基于23个人群组，p=0.11）。只有一项研究报告了从到达到计算机断层扫描解释的时间，两项研究报告了从到达到给药的时间，没有研究报告了从到达到转移到住院的时间，排除了概括。院前延误仍然占延误时间的最大比例。下一个十年为在全世界建立更有效的社区干预措施提供了机会。建立有效的卒中监测系统，以更好地了解和改善急性卒中护理的院前和院内延误至关重要。
The purpose of this study was to systematically review and summarize prehospital and in-hospital stroke evaluation and treatment delay times. We identified 123 unique peer-reviewed studies published from 1981 to 2007 of prehospital and in-hospital delay time for evaluation and treatment of patients with stroke, transient ischemic attack, or stroke-like symptoms. Based on studies of 65 different population groups, the weighted Poisson regression indicated a 6.0% annual decline (p<0.001) in hours/year for prehospital delay, defined from symptom onset to emergency department (ED) arrival. For in-hospital delay, the weighted Poisson regression models indicated no meaningful changes in delay time from ED arrival to ED evaluation (3.1%, p=0.49 based on 12 population groups). There was a 10.2% annual decline in hours/year from ED arrival to neurology evaluation or notification (p=0.23 based on 16 population groups) and a 10.7% annual decline in hours/year for delay time from ED arrival to initiation of computed tomography (p=0.11 based on 23 population groups). Only one study reported on times from arrival to computed tomography scan interpretation, two studies on arrival to drug administration, and no studies on arrival to transfer to an in-patient setting, precluding generalizations. Prehospital delay continues to contribute the largest proportion of delay time. The next decade provides opportunities to establish more effective community based interventions worldwide. It will be crucial to have effective stroke surveillance systems in place to better understand and improve both prehospital and in-hospital delays for acute stroke care.
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影响因子：
6.2
作者：
CULLEY, LL;HENWOOD, DK;HORTON, C
通讯作者：
HORTON, C
影响因子：
9.9
作者：
Barber, PA;Zhang, J;Buchan, AM
通讯作者：
Buchan, AM
影响因子：
2.9
作者：
Boode, Bep;Welzen, Vivian;van Oostenbrugge, Robert
通讯作者：
van Oostenbrugge, Robert
DOI：
10.1080/10903120590962382
发表时间：
2005-07-01
期刊：
Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
影响因子：
--
作者：
Bray, Janet E;Martin, Jenepher;Bladin, Christopher
通讯作者：
Bladin, Christopher
影响因子：
8.3
作者：
ALBERTS, MJ;PERRY, A;BERTELS, C
通讯作者：
BERTELS, C