Abstract 219: What factors influence the decision to refer patients to a stroke center in an Emergency Medical Service Dispatch Center?
| Autor: | Muriel FREDERIC, Anna Ozguler, Thomas Loeb, Michel Baer |
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| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 6 |
| ISSN: | 1941-7705 1941-7713 |
| Popis: | Introduction: Recent findings recommend fibrinolysis for ischemic stroke patients with no age limit and when onset of symptoms is less than 6 hours before treatment. The aim of this study was to identify the factors that influence the decision to refer to a stroke center (SC) in an Emergency Medical Service Dispatch Center (EMS). Methods: A prospective study was implemented in an EMS located in Paris area, from 10/02/2011 to 01/06/2013. Dispatchers initiated 1319 calls with a suspicion of stroke, and transferred them to a Medical Doctor (MD) that took the final decision to refer or not to a SC. Age, gender, socio-economic status of residential area, delay from onset of symptoms to call were first compared at bivariate level. The final analysis was based on backward stepwise logistic regression model with the referral to SC as dependent variable. The [[Unable to Display Character: fi]]nal model included factors associated with referral to a SC at a p level of 0.10. A p value of less than 0.05 was accepted as significant. Results: bivariate comparisons showed younger age, call location and short delay from onset to call as significantly associated with referral to a SC (table 1). In the logistic regression model only age and short delay from onset to call remained associated with the referral to a SC. Women tended to less benefit from SC, but with no statistical significance (table 2). Conclusion: in our study 26% of callers were referred to a SC, age and delay influenced this decision. Enforced implementation of recent recommendations and standard training in stroke recognition will improve EMS pathways to SC. |
| Databáze: | OpenAIRE |
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