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  • 1.
    Andersson Hagiwara, Magnus
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Wireklint Sundström, Birgitta
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Brink, P
    Högskolan väst.
    Herlitz, Johan
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Hansson, P-O
    University of Gothenburg.
    A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service.2018Ingår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke.

    MATERIALS & METHODS: The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital.

    RESULTS: Of 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient's decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital.

    CONCLUSIONS: Patients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.

  • 2.
    Hansson, P-O
    et al.
    Sahlgrenska University Hospital and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
    Andersson Hagiwara, Magnus
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Herlitz, Johan
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Brink, P
    Intensive Care Unit, NU-hospital.
    Wireklint Sundström, Birgitta
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Prehospital assessment of suspected stroke and TIA: an observational study.2019Ingår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404Artikel i tidskrift (Refereegranskat)
    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.

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