Factors associated with use of emergency medical services in patients with acute stroke
Journal
American Journal of Emergency Medicine
Journal Volume
31
Journal Issue
5
Pages
788-791
Date Issued
2013
Author(s)
Chen N.-C.
Huang K.-Y.
Abstract
Purposes The aim of this study was to investigate the factors associated with use of emergency medical services (EMS) in patients with acute stroke. Methods Prospective data on consecutive patients with acute stroke who presented to the emergency department of a university medical center from January 1, 2010, to July 31, 2011, were analyzed. Patients were excluded if they had an unknown residence, had onset of stroke at a nursing home or hospital, or were transferred from another hospital. Variables for all patients with stroke and ischemic stroke who did and did not use EMS were compared. Results In total, 1344 patients (60% male; mean age, 68.7 years) were included. Use of EMS (n = 409; 30.4%) was significantly associated with a higher level of education (??§ 6 years vs < 6 years; odds ratio [OR], 1.69; 95% confidence interval [CI], 1.25-2.29), a higher National Institutes of Health Stroke Scale score (OR, 1.08; 95% CI, 1.05-1.11), altered consciousness (OR, 1.88; 95% CI, 1.25-2.84), and atrial fibrillation (OR, 2.43; 95% CI, 1.71-3.44) after adjustment. For patients with ischemic stroke, use of EMS was significantly higher in cases of cardioembolism (OR, 3.04; 95% CI, 1.40-6.60) and large artery atherothrombosis (OR, 2.10; 95% CI, 1.22-3.62) than lacunar infarction. Conclusion Patients with stroke who have altered consciousness, a higher level of education, a higher National Institutes of Health Stroke Scale score, atrial fibrillation, and cardioembolic stroke were more likely to use EMS. ? 2013 Elsevier Inc.
SDGs
Other Subjects
aged; article; brain ischemia; cerebrovascular accident; educational status; emergency health service; emergency ward; female; health care utilization; heart atrium fibrillation; hospital; human; lacunar stroke; major clinical study; male; nursing home; patient transport; priority journal; risk factor; thrombosis; university hospital; Acute Disease; Aged; Aged, 80 and over; Educational Status; Emergency Medical Services; Emergency Service, Hospital; Female; Health Services Research; Hospitals, University; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Registries; Severity of Illness Index; Stroke; Taiwan; Transportation of Patients
Type
journal article