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The early chain of care and risk of death in acute stroke in relation to the priority given at the dispatch centre: A multicentre observational study
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Prehospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Prehospen)
NU-Hospital Organisation.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Prehospen)ORCID iD: 0000-0003-4139-6235
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, Vol. 16, no 7, 623-631 p.Article in journal (Refereed) Published
Abstract [en]

Background:The early chain of care is critical for stroke patients. The most important part is the so-called 'system delay' i.e. the delay time from call to the emergency medical services until a diagnosis is established (computer tomography).Aim:The purpose of this study was to relate the initial priority level given by the dispatch centre to the early chain of care in acute stroke and to short-term and long-term mortality.Methods:All patients hospitalised with the first and the final diagnosis of acute stroke, 15 December 2010?15 April 2011, were recruited across nine hospitals, each hospital with a stroke care unit.Results:In all, 897 stroke patients were included. Priority at the dispatch centre: 54% received highest priority 1, 41% priority 2 and 5% priority 3. Median system delay from call to emergency medical services until diagnosis by computer tomography was 2 h and 52 min, 4 h and 49 min and 6 h and 33 min respectively in the three priority groups (p<0.0001). There was a similarly strong association between priority level at the dispatch centre and system delay to arrival in a hospital ward, suspicion of stroke by the emergency medical services nurse as well as the physician on hospital admission and the proportion of patients given thrombolysis. Mortality during the subsequent 30 days was 22% among patients with priority 1 and 14% among patients with priority 2.Conclusion:Patients given a lower priority level at the dispatch centre had the longest system delay. Although many of these patients died, the risk of death was highest among those given the highest priority.

Place, publisher, year, edition, pages
2017. Vol. 16, no 7, 623-631 p.
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:hb:diva-12231DOI: 10.1177/1474515117704617ISI: 000412103400008PubMedID: 28417645Scopus ID: 85030251618OAI: oai:DiVA.org:hb-12231DiVA: diva2:1111543
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2017-11-09

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Wireklint Sundström, BirgittaAndersson Hagiwara, MagnusHerlitz, Johan
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