J 2021

New Prehospital Triage for Stroke Patients Significantly Reduces Transport Time of EVT Patients Without Delaying IVT

CABAL, Martin, Linda MACHOVÁ, Daniel VACLAVIK, Petr JASSO, David HOLES et. al.

Basic information

Original name

New Prehospital Triage for Stroke Patients Significantly Reduces Transport Time of EVT Patients Without Delaying IVT

Authors

CABAL, Martin (203 Czech Republic), Linda MACHOVÁ (203 Czech Republic, belonging to the institution), Daniel VACLAVIK (203 Czech Republic), Petr JASSO (203 Czech Republic), David HOLES (203 Czech Republic), Ondřej VOLNÝ (203 Czech Republic, guarantor, belonging to the institution) and Michal BAR (203 Czech Republic)

Edition

Frontiers in Neurology, Lausanne, Frontiers, 2021, 1664-2295

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 4.086

RIV identification code

RIV/00216224:14110/21:00122327

Organization unit

Faculty of Medicine

UT WoS

000668247800001

Keywords in English

prehospital triage; stroke; paramedic; EVT; large vessel occlusion

Tags

International impact, Reviewed
Změněno: 14/9/2021 07:58, Mgr. Tereza Miškechová

Abstract

V originále

Background and Purpose: Ischemic stroke is a leading cause of mortality and morbidity worldwide. The time from stroke onset to treatment impacts clinical outcome. Here, we examined whether changing a triage model from "drip and ship" to "mothership" yielded significant reductions of onset-to-groin time (OGT) in patients receiving EVT and onset-to-needle time (ONT) in IVT-treated patients, compared to before FAST-PLUS test implementation. We also investigated whether the new triage improved clinical outcomes. Methods: In a before/after multicenter study, we evaluated the effects of changing the prehospital triage system for suspected stroke patients in the Moravian-Silesian region, Czech Republic. In the new system, the validated FAST PLUS test is used to differentiate patients with suspected large vessel occlusion and triage-positive patients are transported directly to the CSC. Time metrics and patient data were obtained from the regional EMS database and SITS database. Results: For EVT patients, the median OGT was 213 min in 2015 and 142 min in 2018, and the median TT was 142 min in 2015 and 47 min in 2018. For tPA patients, the median ONT was 110 min in 2015 and 109 min in 2018, and the median TT was 41 min in 2015 and 48 min in 2018. Clinical outcome did not significantly change. The percentages of patients with favorable clinical outcome (mRS 0-2) were comparable between 2015 and 2018: 60 vs. 59% in tPA patients and 40 vs. 44% in EVT patients. Conclusions: The new prehospital triage has yielded shorter OGTs for EVT patients. No changes were found in the onset-to-needle time for IVT-treated patients, or in the clinical outcome at 3 months after stroke onset.

Links

LTC20031, research and development project
Name: Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic
Investor: Ministry of Education, Youth and Sports of the CR, INTER-COST