Tiempo de llegada hospitalaria y pronóstico funcional después de un infarto cerebral: resultados del estudio PREMIER

León-Jiménez, Carolina; Ruiz-Sandoval, José Luís; Chiquete, Erwin; Vega-Arroyo, M.; Araúz, Antonio; Murillo-Bonilla, Luis Manuel; Ochoa-Guzmán, Ana; Carrillo-Loza, Karina; Ramos-Moreno, Alma; Barinagarrementería, Fernando; Cantú-Brito, Carlos

doi:10.1016/j.nrl.2013.05.003

Cited by 22 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies utilized various methods for analyzing the effect of age. In short, being younger was associated both with early ( 63 , 83 , 96 ) and delayed ( 57 , 91 , 126 ) presentation, and similarly older patients were associated with both early ( 37 , 43 , 59 , 77 , 114 ) and delayed ( 56 , 57 , 62 , 74 , 83 , 121 ) presentation. There may be a lack of urgency in younger patients with stroke ( 152 ), and symptoms exhibited by older patients may be more readily interpreted as stroke and perceived as an emergency ( 43 ).…”

Section: Time To Hospital Arrival: Male Versus Female and Patient Agementioning

confidence: 91%

If Time Is Brain Where Is the Improvement in Prehospital Time after Stroke?

Pulvers

Watson

2017

Front. Neurol.

View full text Add to dashboard Cite

Despite the availability of thrombolytic and endovascular therapy for acute ischemic stroke, many patients are ineligible due to delayed hospital arrival. The identification of factors related to either early or delayed hospital arrival may reveal potential targets of intervention to reduce prehospital delay and improve access to time-critical thrombolysis and clot retrieval therapy. Here, we have reviewed studies reporting on factors associated with either early or delayed hospital arrival after stroke, together with an analysis of stroke onset to hospital arrival times. Much effort in the stroke treatment community has been devoted to reducing door-to-needle times with encouraging improvements. However, this review has revealed that the median onset-to-door times and the percentage of stroke patients arriving before the logistically critical 3 h have shown little improvement in the past two decades. Major factors affecting prehospital time were related to emergency medical pathways, stroke symptomatology, patient and bystander behavior, patient health characteristics, and stroke treatment awareness. Interventions addressing these factors may prove effective in reducing prehospital delay, allowing prompt diagnosis, which in turn may increase the rates and/or efficacy of acute treatments such as thrombolysis and clot retrieval therapy and thereby improve stroke outcomes.

show abstract

Section: Time To Hospital Arrival: Male Versus Female and Patient Agementioning

confidence: 91%

If Time Is Brain Where Is the Improvement in Prehospital Time after Stroke?

Pulvers

Watson

2017

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…The purpose of establishing stroke centre is to improve stroke medical staff and facilities, so as to adapt them to the methods of stroke treatment and improve the level of stroke diagnosis and treatment. 7 The US health facility accreditation programme classifies stroke centres into three levels: CSC, PSC and stroke ready hospital. As early as 2000, BAC published a proposal to develop PSC, so as to improve the level of stroke diagnosis and treatment in the USA and improve stroke outcomes.…”

Section: Chapter 3: Regional Cooperative Network Construction Of Stromentioning

confidence: 99%

Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update on organizational stroke management

Lou

Ding

et al. 2020

Stroke Vasc Neurol

View full text Add to dashboard Cite

AimStroke is characterised by high morbidity, mortality and disability, which seriously affects the health and safety of the people. Stroke has become a serious public health problem in China. Organisational stroke management can significantly reduce the mortality and disability rates of patients with stroke. We provide this evidence-based guideline to present current and comprehensive recommendations for organisational stroke management.MethodsA formal literature search of MEDLINE (1 January 1997 through 30 September 2019) was performed. Data were synthesised with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The Chinese Stroke Association’s Levels of Evidence grading algorithm was used to grade each recommendation.ResultsEvidence-based guidelines are presented for the organisational management of patients presenting with stroke. The focus of the guideline was subdivided into prehospital first aid system of stroke, rapid diagnosis and treatment of emergency in stroke centre, organisational management of stroke unit and stroke clinic, construction of regional collaborative network among stroke centres and evaluation and continuous improvement of stroke medical quality.ConclusionsThe guidelines offer an organisational stroke management model for patients with stroke which might help dramatically.

show abstract

“…Previous studies showed that early hospital arrival was a significant factor for better functional outcomes [13][14][15]. However, patients who received reperfusion therapy during the acute phase were included in most of these studies; therefore, better outcomes of early arrivers might be owing to reperfusion therapy.…”

Section: Introductionmentioning

confidence: 99%

Impact of onset-to-door time on outcomes and factors associated with late hospital arrival in patients with acute ischemic stroke

et al. 2021

View full text Add to dashboard Cite

Background and purpose Previous studies have reported that early hospital arrival improves clinical outcomes in patients with acute ischemic stroke; however, whether early arrival is associated with favorable outcomes regardless of reperfusion therapy and the type of stroke onset time is unclear. Thus, we investigated the impact of onset-to-door time on outcomes and evaluated the predictors of pre-hospital delay after ischemic stroke. Methods Consecutive acute ischemic stroke patients who arrived at the hospital within five days of onset from September 2019 to May 2020 were selected from the prospective stroke registries of Seoul National University Hospital and Chung-Ang University Hospital of Seoul, Korea. Patients were divided into early (onset-to-door time, ≤4.5 h) and late (>4.5 h) arrivers. Multivariate analyses were performed to assess the effect of early arrival on clinical outcomes and predictors of late arrival. Results Among the 539 patients, 28.4% arrived early and 71.6% arrived late. Early hospital arrival was significantly associated with favorable outcomes (three-month modified Rankin Scale [mRS]: 0−2, adjusted odds ratio [aOR]: 2.03, 95% confidence interval: [CI] 1.04–3.96) regardless of various confounders, including receiving reperfusion therapy and type of stroke onset time. Furthermore, a lower initial National Institute of Health Stroke Scale (NIHSS) score (aOR: 0.94, 95% CI: 0.90–0.97), greater pre-stroke mRS score (aOR: 1.58, 95% CI: 1.18–2.13), female sex (aOR: 1.71, 95% CI: 1.14–2.58), unclear onset time, and ≤6 years of schooling (aOR: 1.76, 95% CI: 1.03–3.00 compared to >12 years of schooling) were independent predictors of late arrival. Conclusions Thus, the onset-to-door time of≤4.5 h is crucial for better clinical outcome, and lower NIHSS score, greater pre-stroke mRS score, female sex, unclear onset times, and ≤6 years of schooling were independent predictors of late arrival. Therefore, educating about the importance of early hospital arrival after acute ischemic stroke should be emphasized. More strategic efforts are needed to reduce the prehospital delay by understanding the predictors of late arrival.

show abstract

Tiempo de llegada hospitalaria y pronóstico funcional después de un infarto cerebral: resultados del estudio PREMIER

Abstract: A high percentage of patients had short hospital arrival times; however, less than 3% underwent thrombolysis. Although many factors were associated with early hospital arrival, it is a priority to identify in-hospital barriers to performing thrombolysis.

Cited by 22 publications

References 28 publications

If Time Is Brain Where Is the Improvement in Prehospital Time after Stroke?

If Time Is Brain Where Is the Improvement in Prehospital Time after Stroke?

Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update on organizational stroke management

Impact of onset-to-door time on outcomes and factors associated with late hospital arrival in patients with acute ischemic stroke

Contact Info

Product

Resources

About