Abstract
Introduction: In the planning of acute stroke services it is expected that most patients will arrive by emergency ambulance. We examined this assumption and the characteristics of patients influencing treatment and prognosis according to the mode of presentation. Method: A prospective regional database of consecutive acute stroke admissions conducted between 01/09/10–30/09/11. Case ascertainment and transport mode were checked against hospital coding and ambulance dispatch databases.
Results: Eight acute NHS trusts contributed data for a mean of 10.7 months (range: 7–13). 2792 patients received a diagnosis of stroke within 24 hours of admission: 2002 arrivals by emergency ambulance; 538 by private transport or non-emergency ambulance; 252 unknown mode. Emergency ambulance patients were older (76 vs. 69 years), more likely to be from institutional care (10% vs. 1%), with a history of stroke or TIA (31% vs. 22%) and experiencing total anterior circulation symptoms (27% vs. 6%). Their onset-admission time was shorter (mean 5.3 vs. 14.5 hours). In both groups 30% had thrombolysis assessments but the treatment rate was higher following emergency admission (10.2% vs. 4.3%). Patients not attending via emergency ambulance had lower mortality (2% vs. 18%), lower rate of new institutionalisation (1% vs. 6%) and less need for daily carers at discharge (6% vs. 16%).
Conclusion: 79% of patients with an early diagnosis of stroke were admitted by emergency ambulance. Patients admitted by other modes had less severe symptoms and presented later but some still received thrombolysis. This should be considered in the planning of acute stroke services.
Results: Eight acute NHS trusts contributed data for a mean of 10.7 months (range: 7–13). 2792 patients received a diagnosis of stroke within 24 hours of admission: 2002 arrivals by emergency ambulance; 538 by private transport or non-emergency ambulance; 252 unknown mode. Emergency ambulance patients were older (76 vs. 69 years), more likely to be from institutional care (10% vs. 1%), with a history of stroke or TIA (31% vs. 22%) and experiencing total anterior circulation symptoms (27% vs. 6%). Their onset-admission time was shorter (mean 5.3 vs. 14.5 hours). In both groups 30% had thrombolysis assessments but the treatment rate was higher following emergency admission (10.2% vs. 4.3%). Patients not attending via emergency ambulance had lower mortality (2% vs. 18%), lower rate of new institutionalisation (1% vs. 6%) and less need for daily carers at discharge (6% vs. 16%).
Conclusion: 79% of patients with an early diagnosis of stroke were admitted by emergency ambulance. Patients admitted by other modes had less severe symptoms and presented later but some still received thrombolysis. This should be considered in the planning of acute stroke services.
Original language | English |
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Pages (from-to) | 11-11 |
Number of pages | 1 |
Journal | International Journal of Stroke |
Volume | 7 |
Issue number | Supplement 2 |
DOIs | |
Publication status | Published - 1 Dec 2012 |
Event | UK Stroke Forum 2012 Conference - Harrogate, UK Duration: 1 Jan 2012 → … |