Advani Rajiv, Naess Halvor, Kurz Martin
Department of Neurology, Stavanger University Hospital, Stavanger, Norway; Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.
Department of Neurology, Haukeland University Hospital, Bergen, Norway; Institute of Clinical Medicine, University of Bergen, Norway.
J Stroke Cerebrovasc Dis. 2016 Jun;25(6):1467-72. doi: 10.1016/j.jstrokecerebrovasdis.2016.02.026. Epub 2016 Mar 24.
This study evaluates the effect of a mass media intervention (MMI) on the number of admissions to the emergency room (ER) with a suspected acute-onset stroke and on the number of patients treated with intravenous thrombolysis (IVT). The MMI was run for 1 month, with a precampaign month, priming the treatment chain and raising in-hospital awareness.
This study conducted a prospective analysis of all patients admitted to the ER before, during, and after the MMI to assess changes in admission rate and IVT treatment rate. The primary end point was to assess any change in the IVT treatment rate, and the secondary end point was to determine the number of acute stroke admissions to the ER within 4.5 hours of symptom onset.
The MMI resulted in an increased IVT treatment rate from 7.3 to 11.3 patients per month, an increment of 54% (P = .002). This also resulted in IVT treatment percentages as high as 42%. The number of suspected acute stroke admissions to the ER increased from 37.3 to 72.8 patients per month, a 97% increase (P < .0001). The Epinion interviews showed that stroke symptom recognition increased from 66% to 75%.
The MMI produced a significant increase in IVT treatment rate. This increased treatment rate is largely due to the increase in the number of acute stroke admissions to the ER. Targeting the treatment chain before the MMI led to unprecedented IVT treatment percentages. The effect of our MMI lasted for approximately 6 months before tapering off; repeated campaigns are a prerequisite for sustained IVT treatment rates.
本研究评估大众媒体干预（MMI）对疑似急性起病中风患者急诊室（ER）入院人数以及接受静脉溶栓治疗（IVT）患者人数的影响。MMI持续进行1个月，在活动前有1个月的准备期，以启动治疗链并提高院内认知度。
本研究对MMI之前、期间和之后所有入住急诊室的患者进行前瞻性分析，以评估入院率和IVT治疗率的变化。主要终点是评估IVT治疗率的任何变化，次要终点是确定症状发作后4.5小时内急诊室急性中风入院人数。
MMI使IVT治疗率从每月7.3例增加到11.3例，增幅为54%（P = 0.002）。这也导致IVT治疗百分比高达42%。急诊室疑似急性中风入院人数从每月37.3例增加到72.8例，增加了97%（P < 0.0001）。Epinion访谈显示，中风症状识别率从66%提高到75%。
MMI使IVT治疗率显著提高。治疗率的提高很大程度上归因于急诊室急性中风入院人数的增加。在MMI之前针对治疗链进行干预导致了前所未有的IVT治疗百分比。我们的MMI效果在逐渐减弱之前持续了大约6个月；重复开展活动是维持IVT治疗率的前提条件。
