MING-JU HSIEHSUNG-CHUN TANGWEN-CHU CHIANGHuang K.-Y.Chang A.M.PATRICK CHOW-IN KOLI-KAI TSAIJIANN-SHING JENGMATTHEW HUEI-MING MA2021-12-222021-12-2220149296646https://www.scopus.com/inward/record.uri?eid=2-s2.0-84922009031&doi=10.1016%2fj.jfma.2013.10.020&partnerID=40&md5=04eb999108d6ee13cafe635247791a0bhttps://scholars.lib.ntu.edu.tw/handle/123456789/590497Background/Purpose: To determine whether utilization of emergency medical service (EMS) can increase use and expedite delivery of the thrombolytic therapy in acute ischemic stroke patients. Methods: We analyzed consecutive patients presenting to the emergency department (ED) with an ischemic stroke within 72 hours of symptom onset from a prospective stroke registry. Variables associated with early ED arrival (within 3hours of stroke onset) and administration of intravenous thrombolytic therapy were analyzed. Results: From January 1, 2010 to July 31, 2011, there were 1081 patients (62.3% men, age 69.6±13 years) included in this study. Among them, 289 (26.7%) arrived in the ED within 3 hours, and 88 (8.1%) received thrombolytic therapy. Patients who arrived at the ED by EMS (. n=279, 25.8%) were independently associated with earlier ED arrival (adjusted odds ratio=3.68, 95% confidence interval=2.54-5.33), and higher chance of receiving thrombolytic therapy (adjusted odds ratio=3.89, 95% confidence interval=1.86-8.17). Furthermore, utilization of EMS significantly decreased onset-to-needle time by 26 minutes in patients receiving thrombolytic therapy. Conclusion: Utilization of EMS can not only help acute ischemic stroke patients in early presentation to ED, but also effectively facilitate thrombolytic therapy and shorten the onset-to-needle time. ? 2013 .[SDGs]SDG3aged; Article; brain ischemia; emergency health service; emergency ward; female; fibrinolytic therapy; health care delivery; health care utilization; human; major clinical study; male; observational study; prospective study; register; stroke patient; symptom; emergency health service; fibrinolytic therapy; middle aged; multivariate analysis; odds ratio; statistical model; statistics and numerical data; Stroke; time; utilization; very elderly; fibrinolytic agent; tissue plasminogen activator; Aged; Aged, 80 and over; Emergency Medical Services; Emergency Service, Hospital; Female; Fibrinolytic Agents; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Prospective Studies; Registries; Stroke; Thrombolytic Therapy; Time Factors; Tissue Plasminogen Activatorjournal article10.1016/j.jfma.2013.10.020242963082-s2.0-84922009031