Evidence map›Paper›PMID 40165042›Full record

ArticleInternational journal of emergency medicine2025

Emergency medical services utilization in acute stroke in Qatar - an observational cohort study.

Zain A Bhutta, Naveed Akhtar, Tim Harris, Maaret Castren, Yahia Imam, Sameer A Pathan, Guillaume Alinier, Saadat Kamran, Peter A Cameron, Tuukka Puolakka

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Article in International journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

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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

10 authors.

Zain A BhuttaDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar. Zain.bhutta@helsinki.fi.
Naveed AkhtarDepartment of Neurology, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar.
Tim HarrisBlizard Institute of Barts & The London School of Medicine, Queen Mary University of London, London, UK.
Maaret CastrenDepartment of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Yahia ImamDepartment of Neurology, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar.
Sameer A PathanDepartment of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
Guillaume AlinierHamad Medical Corporation Ambulance Service, Doha, Qatar.
Saadat KamranDepartment of Neurology, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar.
Peter A CameronThe Alfred Hospital, Emergency and Trauma Centre & School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Tuukka PuolakkaDepartment of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTimely recanalization improves long-term outcomes in acute ischemic stroke (IS) patients, but most patients present outside the therapeutic window. Emergency Medical Services (EMS) can reduce pre-hospital delay and increase the likelihood of recanalization. We aim to determine the characteristic variations amongst suspected acute stroke patients using EMS.

methodsThis retrospective observational study included all suspected acute stroke patients admitted to a national tertiary care hospital in Qatar from January 2014 to September 2020. We evaluated demographics, clinical features, treatment impact, and associated factors in EMS versus non-EMS transported groups.

resultsDuring the study period, 11,892 patients presented with suspected stroke. Of these, 65.1% used EMS (EMS group) for transportation to the hospital. Median age was comparable between EMS and non-EMS group [52 years; IQR 43-63 vs. 43-62, p < 0.05]. Male to female ratio was 3:1. EMS use in the Qatari population (59.2%) was relatively low. Patients with hemorrhagic stroke (82.4%) had significantly higher EMS use as compared to IS (65.7%) and cerebral venous thrombosis (64.7%); p < 0.001. Symptom onset to ED presentation time was lower in EMS users, with 41.0% arriving within 4.5 h vs. 24.3% in the non-EMS transported group (p < 0.05). Patients with unilateral weakness (66.4%), aphasia (78.2%), neglect (78.2%), dysarthria (68.4%), loss of consciousness (83.3%), and seizures (83.9%) were more likely to use EMS than alternative modes of transportation. Patients attending via EMS had higher rates of thrombolysis than others (82.4% vs. 17.6%; p < 0.001) and a shorter door-to-needle time (56.4 ± 38.2 min vs. 75.7 ± 43.8 min; p < 0.001).

conclusionEMS utilization in acute stroke patients was high and was associated with rapid and higher rates of therapeutic intervention. However, younger age, Arab ethnicity, and less obvious stroke symptoms were associated with lower EMS use, emphasizing the need for targeted public health interventions to improve EMS activations.

Indexed as

Emergency medical servicesEMS utilizationQatarStroke

Identifiers

PMID40165042
PMCPMC11960035

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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.