• Matthew Huei-Ming Ma, Patrick Chow-In Ko, Nai-Chuan Chen, Sung-Chun Tang, Kuang-Yu Huang, Li-Kai Tsai, and Jiann-Shing Jeng.
• Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
• Am J Emerg Med. 2013 May 1;31(5):788-91.

PurposesThe aim of this study was to investigate the factors associated with use of emergency medical services (EMS) in patients with acute stroke.MethodsProspective data on consecutive patients with acute stroke who presented to the emergency department of a university medical center from January 1, 2010, to July 31, 2011, were analyzed. Patients were excluded if they had an unknown residence, had onset of stroke at a nursing home or hospital, or were transferred from another hospital. Variables for all patients with stroke and ischemic stroke who did and did not use EMS were compared.ResultsIn total, 1344 patients (60% male; mean age, 68.7 years) were included. Use of EMS (n = 409; 30.4%) was significantly associated with a higher level of education (≧6 years vs <6 years; odds ratio [OR], 1.69; 95% confidence interval [CI], 1.25-2.29), a higher National Institutes of Health Stroke Scale score (OR, 1.08; 95% CI, 1.05-1.11), altered consciousness (OR, 1.88; 95% CI, 1.25-2.84), and atrial fibrillation (OR, 2.43; 95% CI, 1.71-3.44) after adjustment. For patients with ischemic stroke, use of EMS was significantly higher in cases of cardioembolism (OR, 3.04; 95% CI, 1.40-6.60) and large artery atherothrombosis (OR, 2.10; 95% CI, 1.22-3.62) than lacunar infarction.ConclusionPatients with stroke who have altered consciousness, a higher level of education, a higher National Institutes of Health Stroke Scale score, atrial fibrillation, and cardioembolic stroke were more likely to use EMS.Copyright © 2013 Elsevier Inc. All rights reserved.

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