Observational studyStroke and vascular neurology2020
Emergency medical services use and its association with acute ischaemic stroke evaluation and treatment in Singapore.
Observational study in Stroke and vascular neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Organizational Factors Determining Access to Reperfusion Therapies in Ischemic Stroke-Systematic Literature Review.International journal of environmental research and public health · 2022Pooled it
- Changes in Stroke Hospital Care During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.Stroke · 2021Pooled it
- Impact of emergency medical services on the prognosis in acute ischemic stroke patients receiving reperfusion therapy or usual treatment: a prospective cohort study.BMC emergency medicine · 2026Article
- Status of emergency medical service use for acute ischemic stroke in China.Scientific reports · 2026Article
- Impact of the 2024 Resident Physician Work Stoppage on Acute Hemorrhagic Stroke Admissions: A Single Cerebrovascular-Specialty Hospital Study in South Korea.Healthcare (Basel, Switzerland) · 2025Article
- Emergency medical services utilization in acute stroke in Qatar - an observational cohort study.International journal of emergency medicine · 2025Article
- Decomposing door-to-needle time: insights into workflow delays and quality improvement in acute stroke care.Frontiers in neurology · 2025Article
- Modeling optimal patient transport in a stroke network capable of remote telerobotic endovascular therapy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024Article
- Perceived performance of activities of daily living by stroke patients: key in decision to call EMS and outcomes.Frontiers in neurology · 2023Article
- Emergency medical service utilization among acute ischemic stroke patients in Beijing: An observational study.Frontiers in neurology · 2022Article
- Changes in Prehospital Stroke Care and Stroke Mimic Patterns during the COVID-19 Lockdown.International journal of environmental research and public health · 2021Article
- Influence of interhospital transfer on endovascular thrombectomy outcome in acute ischemic stroke patients: an analysis of the TREAT-AIS registry.Frontiers in neurologyArticle
- Patterns and Predictors of Emergency Medical Services Utilisation by Patients Attending the Emergency Medicine Department of a Tertiary Care Hospital in India.Journal of emergencies, trauma, and shockArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency medical services (EMS) is a critical link in the chain of stroke survival. We aimed to assess EMS use for stroke in Singapore, identify characteristics associated with EMS use and the association of EMS use with stroke evaluation and treatment.
methodsThe Singapore Stroke Registry combines nationwide EMS and public hospital data for stroke cases in Singapore. Multivariate regressions with the generalised estimating equations were performed to examine the association between EMS use and timely stroke evaluation and treatment.
resultsOf 3555 acute ischaemic patients with symptom onset within 24 hours admitted to all five public hospitals between 2015 and 2016, 68% arrived via EMS. Patients who used EMS were older, were less likely to be female, had higher stroke severity by National Institute of Health Stroke Scale and had a higher prevalence of atrial fibrillation or peripheral arterial disease. Patients transported by EMS were more likely to receive rapid evaluation (door-to-imaging time ≤25 min 34.3% vs 11.1%, OR=2.74 (95% CI 1.40 to 5.38)) and were more likely to receive intravenous tissue plasminogen activator (tPA, 22.8% vs 4.6%, OR=4.61 (95% CI 3.52 to 6.03)). Among patients treated with tPA, patients who arrived via EMS were more likely to receive timely treatment than self-transported patients (door-to-needle time ≤60 min 52.6% vs 29.4%, OR=2.58 (95% CI 1.35 to 4.92)).
conclusionsEMS use is associated with timely stroke evaluation and treatment in Singapore. Seamless EMS-Hospital stroke pathways and targeted public campaigns to advocate for appropriate EMS use have the potential to improve acute stroke care.
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Registered trials
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.