Use of ambulance services for patients with suspected stroke

In Norway, Emergency Medical Communication Centres (EMCCs) are responsible for ensuring appropriate medical assistance for time-critical illness and injury, while also prioritising the allocation of available ambulance resources. This study examined the relationship between EMCC dispatches for suspected stroke, the number of patients discharged with a stroke diagnosis, and the time to hospital admission and initiation of thrombolysis.

We conducted a retrospective, descriptive study using anonymised data from the Norwegian Patient Registry and the Norwegian Stroke Registry for the period 2020-2023. We identified the number of EMCC dispatches for suspected stroke, the number of patients diagnosed with stroke, the proportion of stroke patients admitted to hospital within four hours of symptom onset, the proportion treated with thrombolysis, and the proportion receiving thrombolysis within three hours of symptom onset.

EMCC dispatches for suspected stroke increased from 19,104 in 2020 to 29,426 in 2023, representing a rise of 10,322 dispatches (54 %). Over the same period, the number of patients diagnosed with stroke increased from 8934 to 8969 (35 cases; 0.4 %). The proportion of stroke patients admitted to hospital within four hours of symptom onset and the proportion treated with thrombolysis remained stable throughout the study period.

The increase in EMCC dispatches for suspected stroke during the study period was not due to a higher incidence of acute stroke in the population. The findings indicate that the increase was not associated with an increased proportion of stroke patients admitted to hospital within four hours, nor with an increased proportion of patients treated with thrombolysis or receiving thrombolysis within three hours.