Prehospital identification of factors associated with death during one‐year follow‐up after acute stroke

Hansson, Per‐Olof; Hagiwara, Magnus Andersson; Brink, Peter; Herlitz, Johan; Sundström, Birgitta Wireklint

doi:10.1002/brb3.987

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…Death has always been a major threat to acute cerebral infarction. Several studies have found that the severity of admission symptoms, insular infarction, and cerebral infarction in patients with acute cerebral infarction are independent predictors of clinical prognosis [ 27 , 28 ]. We followed up the patients in the observation group for one year and found that the one-year survival rate was 71.05%.…”

Section: Discussionmentioning

confidence: 99%

[Retracted] Expression of miR‐210, miR‐137, and miR‐153 in Patients with Acute Cerebral Infarction

Tian

Zhao

et al. 2021

BioMed Research International

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Aim. To explore the expression levels of miR-210, miR-137, and miR-153 in patients with acute cerebral infarction. Material and Methods. 76 patients with acute cerebral infarction treated in our hospital from April 2016 to October 2017 were enrolled as the observation group. Another 64 normal patients were selected as the control group. The patients were divided into the death and survival groups based on 1-year mortality of patients. qRT-PCR was used to detect the expression of miR-210, miR-137, and miR-153 in the serum of each group. Receiver operating characteristic (ROC) curve was employed to analyze the diagnostic value and predictive value of miR-210, miR-137 and miR-153 death in patients. The correlation between miR-210, miR-137, and miR-153 in the serum of the observation group was analyzed by Pearson’s test. Results. Levels of miR-210 and miR-137 in the observation group were significantly lower than those in the control group, while levels of miR-153 in the observation group were significantly higher than those in the control group (all P < 0.05 ). The ROC curve of diagnosis of acute cerebral infarction showed that the area under curve of miR-210 was 0.836, that of miR-137 was 0.843, and that of miR-153 was 0.842. The 1-year survival rate was 71.05%. The 1-year survival of the low-expression group of miR-210 and miR-137 was significantly lower than that of the high-expression group, while the 1-year survival of the low-expression group of miR-153 was significantly higher than that of the high-expression group (all P < 0.05 ). The ROC curve for predicting death showed that the area under curve of miR-210 was 0.786, that of miR-137 was 0.824, and that of miR-153 was 0.858. Pearson’s correlation analysis showed that the expression of miR-210 was positively correlated with that of miR-137, while miR-137 was negatively correlated with that of miR-153 and miR-210 was negatively correlated with that of miR-153. Conclusion. miR-210, miR-137, and miR-153 have a certain value in the diagnosis and prediction of 1-year death of acute cerebral infarction and may be potential diagnostic and predictive indicators.

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Section: Discussionmentioning

confidence: 99%

[Retracted] Expression of miR‐210, miR‐137, and miR‐153 in Patients with Acute Cerebral Infarction

Tian

Zhao

et al. 2021

BioMed Research International

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“…Hypoxia is a serious condition most often caused by a respiratory or a cardiac dysfunction, and a neurological assessment may be more difficult to perform in a hypoxic patient. It has also been shown that hypoxic stroke patients have a considerably higher mortality rate than non‐hypoxic stroke patients . It is of great importance not only to diagnose stroke correctly but also to diagnose and treat cardiopulmonary comorbidity correctly.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously described the prehospital stroke care in western Sweden in a large observational study . The aim of this sub‐study was to investigate those patients in whom a suspicion of stroke was raised by the EMS clinician before hospital admission and to compare clinical characteristics, circumstances at symptom onset, and clinical symptoms among patients with a final diagnosis of stroke or TIA with patients with other final diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Prehospital assessment of suspected stroke and TIA: An observational study

et al. 2019

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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 multicenter study includes nine emergency hospitals in western Sweden. All patients transported to hospital by ambulance and in whom a suspicion of stroke was raised by the emergency medical service clinician before hospital admission during a four‐month period were included. Results Of 1081 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 were significantly associated with a final diagnosis of stroke or TIA in a prehospital assessment of patients with a suspected stroke.

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“…The risk increased even above 90%. Previous studies have indicated that low oxygen saturation in the early phase is associated with an increased risk of adverse events amongst patients with acute myocardial infarction [ 25 ] and an increased risk of death amongst patients suffering from stroke [ 26 ]. The mechanisms behind these findings can only be speculated upon.…”

Section: Discussionmentioning

confidence: 99%

Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study

et al. 2022

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Background Patients who call for emergency medical services (EMS) due to abdominal pain suffer from a broad spectrum of diseases, some of which are time sensitive. As a result of the introduction of the concept of ‘optimal level of care‘, some patients with abdominal pain are triaged to other levels of care than in an emergency department (ED). We hypothesised that it could be challenging in a patient safety perspective. Aim This study aims to describe consecutive patients who call for EMS due to abdominal pain and are triaged to self-care by EMS clinicians. Methods This was an observational study performed in an EMS organisation in Western Sweden during 2020. The triage tool Rapid Emergency Triage and Treatment System (RETTS), which included Emergency Signs and Symptom (ESS) codes, was used to find medical records where patients with abdominal pain have been triaged to self-care and 194 patients was included in the study. Results Of total 48,311 ambulance missions, A total of 1747 patients were labelled with ESS code six (abdominal pain), including 223 (12.8%) who were given the code for self-care and 194 who were further assessed by the research group. Of these patients, 32 (16.3%) had a return visit within 96 hours due to the same symptoms and 11 (5.6%) were hospitalised. In six of these patients, the EMS triage was evaluated retrospectively and assessed as inappropriate. These patients had a final diagnosis of ruptured abdominal aneurysm (n = 1), acute appendicitis with peritonitis (n = 2) and acute pancreatitis (n = 3). All these patients required extensive evaluation and different treatments, including acute surgery, antibiotics and fluid therapy. Conclusion Amongst the 1747 patients assessed by EMS due to abdominal pain, 223 (12.8%) were triaged to self-care. Of the 194 patients who were further assessed, 16.3% required a return visit to the ED within 96 hours and 5.6% were hospitalised. Six patients had obvious time-sensitive conditions. Our study highlights the difficulties in the early assessment of abdominal pain and the requirement for an accurate decision support tool.

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Prehospital identification of factors associated with death during one‐year follow‐up after acute stroke

Cited by 6 publications

References 21 publications

[Retracted] Expression of miR‐210, miR‐137, and miR‐153 in Patients with Acute Cerebral Infarction

[Retracted] Expression of miR‐210, miR‐137, and miR‐153 in Patients with Acute Cerebral Infarction

Prehospital assessment of suspected stroke and TIA: An observational study

Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study

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