Factors associated with the activation of emergency medical services in patients with acute stroke: a prospective study

To identify factors associated with activation of emergency medical services (EMS) in stroke.

Cross-sectional study of all patients admitted with stroke to Hospital Universitario de Burgos in Spain between September 1, 2015, and August 31, 2016. We recorded sociodemographic, clinical, behavioral, cognitive, and context information and explored possible associations with calls for EMS units.

Three hundred eleven patients were included. EMS units were activated in 171 cases (55%) associated with an assessment that the patient was unable to manage the health situation from the onset of symptoms (adjusted odds ratio [OR], 6.95; 95% CI, 3.64-13.26), a witness's call for help (rather than the patient's) (OR, 5.68; 95% CI, 2.99-10.83), serious neurological deficit defined by a score over 16 on the National Institute of Health Stroke Scale (OR, 4.51; 95% CI, 1.10-18.46), a patient's awareness of serious symptoms leading to a call for help (OR, 4.03; 95% CI, 1.42-11.42), and a patient's history of high blood pressure (OR, 2.38; 95% CI, 1.25-4.54).

Calls for EMS attendance from either a patient or a witness are associated with objective signs of severe stroke and subjective perception of severity.