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Multicenter Study Observational Study
Prehospital care process and hospital outcomes in stroke-code cases: comparison of basic and advance life support ambulance attendance.
- Silvia Solà Muñoz, María Del Mar Escudero Campillo, Cristina Soro Borrega, Youcef Azeli, Soledad Querol Gil, Antoni Ruiz, Gemma Albacete, Olga Moreno Peral, Sergi Lluch, Sergio Amaro Delgado, Silva BlasYolandaYHospital Doctor Josep Trueta, Girona, España., Xabier Urra, Dolores Cocho Calderón, Joan Martí Fàbregas, Marc Ribó Jacobi, Cardona PortelaPerePHospital Universitari de Bellvitge, Barcelona, España., Francisco Purroy García, Esther Duarte Oller, Verónica Hidalgo Benítez, Alan Flores, Marta Rubiera, Ernest Palomeras, Álvaro García-Tornel, Rosa Suñer Soler, Daniel Vilar Roquet, Mercè Salvat-Plana, Anna Ramos Pachón, Natalia Pérez de la Ossa Herrero, and Xavier Jiménez Fàbrega.
- Sistema d'Emergències Mèdiques, Barcelona, España.
- Emergencias. 2023 Jun 1; 35 (3): 167175167-175.
ObjectivesTo study prehospital care process in relation to hospital outcomes in stroke-code cases first attended by 2 different levels of ambulance. To analyze factors associated with a satisfactory functional outcome at 3 months.Material And MethodsProspective multicenter observational cohort study. All stroke-code cases attended by prehospital emergency services from January 2016 to April 2022 were included. Prehospital and hospital variables were collected. The classificatory variable was type of ambulance attending (basic vs advanced life support). The main outcome variables were mortality and functional status after ischemic strokes in patients who underwent reperfusion treatment 90 days after the ischemic episode.ResultsOut of 22 968 stroke-code activations, ischemic stroke was diagnosed in 12 467 patients (54.3%) whose functional status was good before the episode. Basic ambulances attended 93.1%; an advanced ambulance was ordered in 1.6% of the patients. Even though there were differences in patient and clinical characteristics recorded during the prehospital process, type of ambulance was not independently associated with mortality (adjusted odds ratio [aOR], 1.1; 95% CI, 0.77-1.59) or functional status at 3 months (aOR, 1.05; 95% CI, 0,72-1,47).ConclusionThe percentage of patient complications in stroke-code cases attended by basic ambulance teams is low. Type of ambulance responding was not associated with either mortality or functional outcome at 3 months in this study.
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