Faiz Kashif Waqar, Sundseth Antje, Thommessen Bente, Rønning Ole Morten
Nevroklinikken Akershus universitetssykehus og Helsetjenesteforskning Akershus universitetssykehus.
Nevroklinikken Akershus universitetssykehus.
Tidsskr Nor Laegeforen. 2017 Jun 6;137(11):798-802. doi: 10.4045/tidsskr.16.0512. eCollection 2017 Jun.
Too few patients with acute stroke receive thrombolytic therapy owing to the limited time window for treatment and prehospital delay. The purpose of this study is to describe the prehospital path for patients with acute stroke and, in particular, what distinguishes patients who contact the Emergency Medical Communication Centre (EMCC) from those who contact their general practitioner (GP) or Out-of-hours (OOH) services.
Patients with acute cerebral infarction and intracerebral haemorrhage admitted to the Stroke Unit, Department of Neurology, Akershus University Hospital, were included. Data on the prehospital path (prehospital delay, medical contacts) were collected over the period 15 April 2009 – 1 April 2010.
A total of 299 patients were included in the study. The median age was 75 years and 48.5 % were women. In all, 63.9 % of patients with acute stroke called the EMCC, and 93.7 % of these were taken directly to hospital by ambulance. Of those who called the GP’s office or OOH services, 60.7 % were asked to go to the GP’s office or OOH services in person. Patients who called and attended the GP’s office or OOH services had milder neurological deficits (p < 0.001) and longer patient delay (p = 0.018) than those who called the EMCC.
Six out of ten patients who contacted the primary health care services were asked to go to the GP’s office/OOH services in person, which resulted in unnecessary delay. The findings from this study may indicate a need for specific training of this group of health care professionals in the prompt handling of patients with possible stroke.
由于治疗时间窗有限以及院前延误，接受溶栓治疗的急性中风患者过少。本研究的目的是描述急性中风患者的院前就医路径，尤其是联系紧急医疗通讯中心（EMCC）的患者与联系全科医生（GP）或非工作时间（OOH）服务的患者之间的区别。
纳入阿克什胡斯大学医院神经内科卒中单元收治的急性脑梗死和脑出血患者。收集2009年4月15日至2010年4月1日期间的院前就医路径数据（院前延误、医疗接触情况）。
本研究共纳入299例患者。中位年龄为75岁，女性占48.5%。急性中风患者中，63.9%呼叫了EMCC，其中93.7%由救护车直接送往医院。在呼叫全科医生办公室或非工作时间服务的患者中，60.7%被要求亲自前往全科医生办公室或非工作时间服务处。呼叫并前往全科医生办公室或非工作时间服务处的患者，其神经功能缺损较呼叫EMCC的患者轻（p<0.001），患者延误时间更长（p = 0.018）。
联系基层医疗服务的患者中，十分之六被要求亲自前往全科医生办公室/非工作时间服务处，这导致了不必要的延误。本研究结果可能表明，需要对这组医疗保健专业人员进行关于快速处理可能中风患者的特定培训。
