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评估急性缺血性中风患者的医院前和医院内工作流程和时间间隔

Mikko Helander¹, Timo Iirola¹, Pauli Ylikotila²

¹Department of Emergency Medical Services, Turku University Hospital and University of Turku, Turku, Finland.

|April 22, 2025

概括

优化紧急医疗服务 (EMS) 工作流可以减少急性缺血性中风 (AIS) 患者的现场时间 (OST),改善结果. 减少OST是改善中风护理的关键,尽管医院前时间达到国家目标.

科学领域:

神经学神经学
紧急医疗紧急医疗
公共卫生公共卫生

背景情况:

急性缺血性中风 (AIS) 是全球死亡和残疾的主要原因.
改善患者的治疗结果取决于快速的回治疗方法.
虽然住院时间有所改善,但AIS的医院前间隔仍然是一个挑战.

研究的目的:

通过使用医院前和医院内数据,全面了解AIS患者预后.
确定影响医院前现场时间 (OST) 的因素.
评估时间间隔对患者结果的影响.

主要方法:

在图尔库大学医院 (2022) 接受IVT和/或EVT治疗的174名AIS患者的回顾性分析.
评估医院前和医院内护理记录,重点关注时间间隔.
二元物流回归用于识别OST和有利结果的预测因素.

主要成果:

平均EMS现场时间 (OST) 是19分钟.
诸如公寓设置,锁上门,头和现场测量等因素延长了OST.
较长的OST,症状严重程度和性别对结果产生了负面影响;中风代码调度和FAST标志缩短了OST.
在医院的门到针时间 (DNT) 平均为14分钟 (IVT) 和11分钟 (IVT+EVT).
预先通知EMS与更短的住院时间相关.

结论:

为EMS在识别中风时提出了诊断挑战.
医院前的OST符合国家目标,但工作流程优化可以进一步减少延误.
在EMS协议中针对性干预对于改善AIS患者的治疗结果至关重要.

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