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Prehospital assessment of suspected stroke and TIA: an observational study.
Sahlgrenska University Hospital and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. (PreHospen)
Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.ORCID-id: 0000-0003-4139-6235
Intensive Care Unit, NU-hospital.
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2019 (Engelska)Ingår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

BACKGROUND: Symptoms related to stroke diverge and may mimic many other conditions.

AIMS: To evaluate clinical findings among patients with a clinical suspicion of stroke in a prehospital setting and find independent predictors of a final diagnosis of stroke or transient ischemic attack (TIA) METHODS: An observational multi-centre study including nine emergency hospitals in western Sweden. All patients transported to hospital by ambulance and in whom a suspicion of stroke was raised by the EMS clinician before hospital admission during a four-month period were included.

RESULTS: Of 1,081 patients, a diagnosis of stroke was confirmed at hospital in 680 patients (63%), while 69 (6%) were diagnosed as TIA and 332 patients (31%) received other final diagnoses. In a multiple logistic regression analysis, factors independently associated with a final diagnosis of stroke or TIA were increasing age, odds ratio (OR) per year: 1.02, p=0.007, a history of myocardial infarction (OR: 1.77, p= 0.01), facial droop (OR: 2.81, p<0.0001), arm weakness (OR: 2.61, p<0.0001), speech disturbance (OR: 1.92, p<0.0001) and high systolic blood pressure (OR: 1.50, p=0.02), while low oxygen saturation was significantly associated with other diagnoses (OR: 0.41, p=0.007). More than half of all patients among patients with both stroke/TIA and other final diagnoses died during the five-year follow-up.

CONCLUSIONS: Seven factors including the three symptoms included in the Face Arm Speech Test (FAST) were significantly associated with a final diagnosis of stroke or TIA in a prehospital assessment of patients with a suspected stroke. This article is protected by copyright. All rights reserved.

Ort, förlag, år, upplaga, sidor
2019.
Nyckelord [en]
Emergency Medical Services, diagnosis, mortality, stroke
Nationell ämneskategori
Annan medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:hb:diva-16022DOI: 10.1111/ane.13107PubMedID: 31009075OAI: oai:DiVA.org:hb-16022DiVA, id: diva2:1306667
Tillgänglig från: 2019-04-24 Skapad: 2019-04-24 Senast uppdaterad: 2019-04-29Bibliografiskt granskad

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Andersson Hagiwara, MagnusHerlitz, JohanWireklint Sundström, Birgitta

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