Morales-Ortiz A, Amorín M, Fages E M, Moreno-Escribano A, Villaverde-González R, Martínez-Navarro M L, Marín-Marín J, Marín-Muñoz J, Gómez-Espuch J, García-Medina A M, Escribano-Soriano J B
Hospital Santa María del Rosell, Cartagena, Spain.
Rev Neurol. 2006;42(2):68-72.
To examine the use of extra-hospital emergency systems in the urgent care of stroke patients in our region and their influence on the time required to reach hospital, the time needed to perform an urgent computerised axial tomography (CAT) scan and the delay in receiving attention from the specialist.
Samples were collected from 232 stroke patients out of the total number admitted to our hospitals. Data about the stroke were collected prospectively, and included the arrival time, the time required to perform the CAT scan and the time the specialist devoted to attending the patient. Data were also gathered about the different extra-hospital transport and emergency systems. A statistical analysis was performed to determine the effect of using the extra-hospital emergency procedures on the different variables.
A total of 53.6% of patients arrived within the first three hours. 38.7% went straight to hospital, 25% visited extra-hospital Emergency Services first, and 18.5% made a prior visit to Primary Care. 51.5% found their own way to the hospital and 46.7% arrived by ambulance. Mean time taken to perform an urgent CAT scan: 190.4 minutes; mean time required for specialist attention: 25.65 hours. The only statistically significant relation was the use of extra-hospital emergency systems and health care transport according to the type of stroke: both were more likely to be used in cases of haemorrhagic stroke.
In hospitals in the Murcia region, the use of the extra-hospital emergency system and the means of transport utilised do not affect the time stroke patients take to reach hospital or the time needed to perform an urgent CAT scan or the delay in receiving attention from a specialist; the aetiology of the stroke does, however, influence the use of such services.
研究本地区院外急救系统在卒中患者紧急救治中的应用情况,以及其对患者到达医院所需时间、进行紧急计算机断层扫描(CAT)所需时间和获得专科医生诊治延迟时间的影响。
从我院收治的卒中患者总数中抽取232例患者作为样本。前瞻性收集卒中相关数据,包括到达时间、进行CAT扫描所需时间以及专科医生诊治患者所用时间。还收集了不同的院外转运和急救系统相关数据。进行统计分析以确定采用院外急救程序对不同变量的影响。
共有53.6%的患者在最初三小时内到达。38.7%的患者直接前往医院,25%的患者先前往院外急救服务机构,18.5%的患者先去了初级保健机构。51.5%的患者自行前往医院,46.7%的患者由救护车送达。紧急CAT扫描的平均用时:190.4分钟;专科医生诊治的平均用时:25.65小时。唯一具有统计学意义的关联是根据卒中类型使用院外急救系统和医疗转运:在出血性卒中病例中更有可能使用这两者。
在穆尔西亚地区的医院,院外急救系统的使用和所采用的交通方式不会影响卒中患者到达医院的时间、进行紧急CAT扫描所需时间或获得专科医生诊治的延迟时间;然而,卒中的病因确实会影响此类服务的使用。