Meng Danyang, Zhou Xuyou, Gao Yang, Lu Yanjing, Lu Xia, Jin Tingyu, Hu Jin
Department of Neurology, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
Jiaxing Institute of Arteriosclerotic Diseases, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
BMJ Open. 2025 Mar 5;15(3):e087326. doi: 10.1136/bmjopen-2024-087326.
This study aims to evaluate and compare the clinical differences in intravenous thrombolytic therapy among patients with cerebral infarction transported to the hospital by private cars versus ambulances in Jiaxing, a non-supersized city in China. It also sought to examine the impact of different transportation methods on emergency department arrival times, delays in initiating thrombolytic therapy and final clinical prognosis. The findings aim to provide a basis for optimising emergency treatment protocols and improving outcomes for patients with cerebral infarction.
Data on age, gender, height, weight, body mass index, season, time of day (day vs night), modified Rankin Scale scores, door-to-needle time (DNT) and onset-to-needle time (ONT) were retrospectively collected from 808 patients admitted to the emergency department of the Affiliated Hospital of Jiaxing University for intravenous thrombolysis between January 2019 and September 2022. The data were analysed and compared.
A retrospective cohort study conducted in Jiaxing, China.
The primary outcomes were DNT and ONT.
Among the 808 eligible patients, 279 (34.53%) were transported by ambulance, and 529 (65.47%) arrived by private car. Patients in the private car group were younger on average than those in the ambulance group (aged 64.70 vs 68.41 years). Although ambulance transport resulted in shorter prehospital transportation times (113.89 vs 127.38 min), patients arriving by private car had shorter thrombolytic therapy initiation times (39.90 vs 36.30 min). At admission, the National Institutes of Health Stroke Scale scores were higher in the ambulance group (4 vs 2), indicating more severe conditions and a greater proportion of patients requiring bridging thrombectomy after thrombolysis (7.53% vs 3.02%).
In non-supersized cities, private car transportation for acute patients with cerebral infarction may lead to shorter DNT and ONT compared with those in ambulance transport. However, patients transported by ambulance tended to have more severe conditions, highlighting the importance of tailored emergency response strategies.
本研究旨在评估和比较在中国非超大型城市嘉兴，乘坐私家车与救护车前往医院的脑梗死患者接受静脉溶栓治疗的临床差异。研究还试图考察不同交通方式对急诊科到达时间、溶栓治疗启动延迟以及最终临床预后的影响。研究结果旨在为优化急诊治疗方案和改善脑梗死患者的治疗效果提供依据。
回顾性收集了2019年1月至2022年9月期间在嘉兴学院附属医院急诊科接受静脉溶栓治疗的808例患者的年龄、性别、身高、体重、体重指数、季节、一天中的时间（白天与夜晚）、改良Rankin量表评分、门到针时间（DNT）和发病到针时间（ONT）等数据，并进行分析和比较。
在中国嘉兴进行的一项回顾性队列研究。
主要观察指标为DNT和ONT。
在808例符合条件的患者中，279例（34.53%）乘坐救护车前往，529例（65.47%）乘坐私家车到达。私家车组患者的平均年龄比救护车组患者年轻（分别为64.70岁和68.41岁）。虽然救护车运送导致院前运输时间较短（113.89分钟对127.38分钟），但乘坐私家车到达的患者溶栓治疗启动时间较短（39.90分钟对36.30分钟）。入院时，救护车组的美国国立卫生研究院卒中量表评分较高（4分对2分），表明病情更严重，溶栓后需要桥接取栓术的患者比例更高（7.53%对3.02%）。
在非超大型城市，急性脑梗死患者乘坐私家车前往医院可能比乘坐救护车导致更短的DNT和ONT。然而，乘坐救护车运送的患者病情往往更严重，这凸显了制定针对性应急响应策略的重要性。
