Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 45, Gothenburg, Sweden.
Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden.
Sci Rep. 2023 Nov 27;13(1):20799. doi: 10.1038/s41598-023-48007-6.
Stroke patients not eligible for acute intervention often have low priority and may spend long time at the emergency department (ED) waiting for admission. The aim of this retrospective case-control register study was to evaluate outcomes for such "low priority" stroke patients who were transported via Fast Track directly to the stroke unit, according to pre-specified criteria by emergency medical service (EMS). The outcomes of Fast Track patients, transported directly to stroke unit (cases) were compared with the outcomes of patients who fulfilled these critera for Fast Track, but instead were transported to the ED (controls). In all, 557 cases and 509 controls were identified. The latter spent a mean time of 237 min in the ED before admission. The 90-day mortality rate was 12.9% for cases and 14.7% for controls (n.s.). None of the secondary outcome events differed significantly between the groups: 28-day mortality rate; death rate during hospitalisation; proportion of pneumonias, falls or pressure ulcers; or health-related outcomes according to the EQ-5D-5L questionnaire. These findings indicates that the Fast Track to the stroke unit by an EMS is safe for selected stroke patients and could avoid non-valuable time in the ED.
不符合急性介入治疗条件的中风患者通常优先级较低，可能需要在急诊部（ED）等待很长时间才能入院。本回顾性病例对照登记研究的目的是根据急诊医疗服务（EMS）的预定标准，评估根据这些标准通过快速通道直接送往卒中单元的此类“低优先级”卒中患者的结局。根据预先指定的标准，将直接送往卒中单元的快速通道患者（病例）的结局与符合快速通道标准但被送往 ED 的患者（对照组）的结局进行比较。总共确定了 557 例病例和 509 例对照。后者在入院前在 ED 中平均花费 237 分钟。90 天死亡率为病例组 12.9%，对照组 14.7%（无统计学意义）。两组之间没有显著差异的次要结局事件：28 天死亡率；住院期间死亡率；肺炎、跌倒或压疮的比例；或根据 EQ-5D-5L 问卷的健康相关结局。这些发现表明，对于选定的中风患者，由 EMS 快速通道到卒中单元是安全的，并且可以避免在 ED 中浪费时间。
