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Prehospital transfer medicalization increases thrombolysis rate in acute ischemic stroke. A French stroke unit experience.
Joux, Julien; Olindo, Stéphane; Girard-Claudon, Annette; Chausson, Nicolas; Saint-Vil, Martine; Signate, Aissatou; Edimonana, Mireille; Jeannin, Severine; Aveillan, Mathieu; Cabre, Philippe; Smadja, Didier.
Afiliação
  • Joux J; Neurology and Stroke Center, University Hospital of Fort-de-France, Martinique. julien_joux@hotmail.com
Clin Neurol Neurosurg ; 115(9): 1583-5, 2013 Sep.
Article em En | MEDLINE | ID: mdl-23489443
OBJECTIVES: Narrow therapeutic window is a major cause of thrombolysis exclusion in acute ischemic stroke. Whether prehospital medicalization increases t-PA treatment rate is investigated in the present study. PATIENTS AND METHODS: Intrahospital processing times and t-PA treatment were analyzed in stroke patients calling within 6h and admitted in our stoke unit. Patients transferred by our mobile medical team (SAMU) and by Fire Department (FD) paramedics were compared. RESULTS: 193 (61.6%) SAMU patients and 120 (38.4%) FD patients were included within 30 months. Clinical characteristics and onset-to-call intervals were similar in the two groups. Mean door-to-imaging delay was deeply reduced in the SAMU group (52 vs. 159 min, p<0.0001) and was <25 min in 50% of SAMU patients and 14% of FD patients (p<0.0001). SAMU management was the only independent factor of early imaging (p=0.0006). t-PA administration rate was higher in SAMU group than in FD group (42% vs. 28%, p=0.04). Proportion of patients with delayed therapeutic window was higher in FD group than in SAMU group (38% vs. 26%, p<0.0001). CONCLUSION: Prehospital transfer medicalization promotes emergency room bypass, direct radiology room admission and high thrombolysis rate in acute ischemic stroke.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Trombolítica / Transferência de Pacientes / Acidente Vascular Cerebral / Serviços Médicos de Emergência / Medicalização Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Clin Neurol Neurosurg Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Martinica País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Trombolítica / Transferência de Pacientes / Acidente Vascular Cerebral / Serviços Médicos de Emergência / Medicalização Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Clin Neurol Neurosurg Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Martinica País de publicação: Holanda