Observational studyJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2020
Early Stroke Recognition and Time-based Emergency Care Performance Metrics for Intracerebral Hemorrhage.
Observational study in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Early Recognition and Referral of Acute Stroke in Primary and Emergency Care: A Systematic Review.The western journal of emergency medicine · 2026Pooled it
- The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2025Article
- Prehospital identification of intracerebral haemorrhage: a scoping review of early clinical features and portable devices.BMJ open · 2024Article
- Time to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage.JAMA neurology · 2024Article
- Article
- Cerebrovascular disease hospitalizations following emergency department headache visits: A nested case-control study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Article
- Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes.Neuropsychiatric disease and treatment · 2021Review
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Authors and funding
8 authors.
Funding
Abstract
BACKGROUND AND
aimPerformance measures have been extensively studied for acute ischemic stroke, leading to guideline-established benchmarks. Factors influencing care efficiency for intracerebral hemorrhage (ICH) are not well delineated. We sought to identify factors associated with early recognition of ICH and to assess the association between early recognition and completion of emergency care tasks.
methodsConsecutive patients with spontaneous ICH were enrolled in an observational cohort study conducted from 2009 to 2017 at an urban comprehensive stroke center, excluding patient transferred from other hospitals. We used stroke team activation as the indicator of early recognition and measured completion times for multiple ICH-relevant performance metrics including door to computed tomography (CT) acquisition and door to hemostatic medication initiation.
resultsWe studied 204 cases. All stroke-related performance times were faster in patients managed with stroke team activation compared to no activation, including quicker door to CT acquisition (median 24 versus 48 minutes, P < .001) and door to hemostatic medication initiation (63 versus 99 minutes, P = .005). These associations were confirmed in adjusted models. Stroke codes were activated in 43% of cases and were more likely in patients with shorter onset-to-arrival times, higher National Institutes of Health Stroke Scale scores, and higher Glasgow Coma Scale scores.
conclusionsStroke team activation was associated with more rapid diagnostic and therapeutic interventions for patients with ICH, but activation did not occur in the majority of cases, implying absence of early recognition. A stroke team activation process improves care performance, but leveraging the advantages of existing systems will require improved triage tools to identify ICH in the acute setting.
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