Evidence map›Paper›PMID 27139735›Full record

Observational studyJournal of the American Heart Association2016

Prehospital Phase of the Stroke Chain of Survival: A Prospective Observational Study.

Tuukka Puolakka, Daniel Strbian, Heini Harve, Markku Kuisma, Perttu J Lindsberg

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tuukka PuolakkaEmergency Medical Services, Helsinki University Hospital, Helsinki, Finland tuukka.puolakka@hus.fi.
Daniel StrbianDepartment of Neurology and Clinical Neurosciences, Helsinki University Hospital, Helsinki, Finland.
Heini HarveEmergency Medical Services, Helsinki University Hospital, Helsinki, Finland.
Markku KuismaEmergency Medical Services, Helsinki University Hospital, Helsinki, Finland.
Perttu J LindsbergDepartment of Neurology and Clinical Neurosciences, Helsinki University Hospital, Helsinki, Finland Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of Helsinki, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFew studies have discussed the emergency call and prehospital care as a continuous process to decrease the prehospital and in-hospital delays for acute stroke. To identify features associated with early hospital arrival (<90 minutes) and treatment (<120 minutes), we analyzed the operation of current dispatch protocol and emergency medical services and compared stroke recognition by dispatchers and ambulance crews. METHODS AND

resultsThis was a 2-year prospective observational study. All stroke patients who were transported to the hospital by emergency medical services and received recanalization therapy were recruited for the study. For a sample of 308 patients, the stroke code was activated in 206 (67%) and high priority was used in 258 (84%) of the emergency calls. Emergency medical services transported 285 (93%) of the patients using the stroke code and 269 (87%) using high priority. In the univariate analysis, the most dominant predictors of early hospital arrival were transport using stroke code (P=0.001) and high priority (P=0.002) and onset-to-call (P<0.0001) and on-scene times (P=0.052). In the regression analysis, the influences of high-priority transport (P<0.01) and onset-to-call time (P<0.001) prevailed as significant in both dichotomies of early arrival and treatment. The on-scene time was found to be surprisingly long (>23.5 minutes) for both early and late-arriving patients.

conclusionsFast emergency medical services activation and ambulance transport promoted early hospital arrival and treatment. Although patient-dependent delays still dominate the prehospital process, it should be ensured that the minutes on the scene are well spent.

Indexed as

Emergency Medical DispatchEmergency Medical ServicesTime-to-TreatmentTransportation of PatientsAgedAged, 80 and overCohort StudiesFemaleFinlandHumansLogistic ModelsMaleMiddle AgedProspective StudiesStrokeSurvival Rateemergency medical servicesstroketime factors

Identifiers

PMID27139735
PMCPMC4889170

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.