Emergency medical services use by stroke patients: a population-based study

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Emergency medical services (EMS) utilization by stroke patients shows significant variability, ranging from 38% to 65%.
• Understanding factors influencing EMS use is crucial for timely stroke intervention and improving patient outcomes.
• Previous studies highlight the need for population-based data to accurately assess EMS use patterns in stroke patients.

Purpose of the Study:

• To determine the proportion of stroke patients who utilized EMS in a defined population.
• To investigate associations between patient demographics, stroke characteristics, and location of stroke onset with EMS use.
• To identify predictors of EMS utilization among acute stroke patients.

Main Methods:

• A population-based epidemiological study was conducted in the Cincinnati area, identifying stroke and transient ischemic attack patients from 1.3 million individuals in 1999.
• Data were collected through abstraction of patient charts and EMS records by research nurses and reviewed by study physicians.
• Logistic regression analysis was employed to identify factors associated with EMS use.

Main Results:

• Of 3008 eligible stroke patients (mean age 74 years, 17% Black, 45% male), 50.9% used EMS.
• Factors significantly associated with EMS use included older age, greater prestroke disability, higher stroke severity, and hemorrhagic stroke.
• Stroke occurring at work was also associated with increased EMS utilization, while race, sex, and prior stroke were not significant predictors.

Conclusions:

• Approximately half of stroke patients in this population-based study utilized EMS.
• Older patients, those with more severe strokes (including hemorrhagic stroke), and those experiencing stroke at work were more likely to use EMS.
• These findings underscore the importance of considering patient and stroke characteristics when analyzing EMS use patterns.