LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 3 of total 3

Search options

  1. Article ; Online: Prehospital Stroke Triage: A Modeling Study on the Impact of Triage Tools in Different Regions.

    Duvekot, Martijne H C / Garcia, Bjarty L / Dekker, Luuk / Nguyen, Truc My / van den Wijngaard, Ido R / de Laat, Karlijn F / de Schryver, Els L L M / Kloos, Loet M H / Aerden, Leo A M / Zylicz, Stas A / Bosch, Jan / van Belle, Eduard / van Zwet, Erik W / Rozeman, Anouk D / Moudrous, Walid / Vermeij, Frédérique H / Lingsma, Hester F / Bakker, Jeannette / van Doormaal, Pieter Jan /
    van Es, Adriaan C G M / van der Lugt, Aad / Wermer, Marieke J H / Dippel, Diederik W J / Kerkhoff, Henk / Roozenbeek, Bob / Kruyt, Nyika D / Venema, Esmee

    Prehospital emergency care

    2023  Volume 27, Issue 5, Page(s) 630–638

    Abstract: Background and purpose: Direct transportation to a thrombectomy-capable intervention center is beneficial for patients with ischemic stroke due to large vessel occlusion (LVO), but can delay intravenous thrombolytics (IVT). The aim of this modeling ... ...

    Abstract Background and purpose: Direct transportation to a thrombectomy-capable intervention center is beneficial for patients with ischemic stroke due to large vessel occlusion (LVO), but can delay intravenous thrombolytics (IVT). The aim of this modeling study was to estimate the effect of prehospital triage strategies on treatment delays and overtriage in different regions.
    Methods: We used data from two prospective cohort studies in the Netherlands: the Leiden Prehospital Stroke Study and the PRESTO study. We included stroke code patients within 6 h from symptom onset. We modeled outcomes of Rapid Arterial oCclusion Evaluation (RACE) scale triage and triage with a personalized decision tool, using drip-and-ship as reference. Main outcomes were overtriage (stroke code patients incorrectly triaged to an intervention center), reduced delay to endovascular thrombectomy (EVT), and delay to IVT.
    Results: We included 1798 stroke code patients from four ambulance regions. Per region, overtriage ranged from 1-13% (RACE triage) and 3-15% (personalized tool). Reduction of delay to EVT varied by region between 24 ± 5 min (
    Conclusions: In this modeling study, we showed that prehospital triage reduced time to EVT without disproportionate IVT delay, compared to a drip-and-ship strategy. The effect of triage strategies and the associated overtriage varied between regions. Implementation of prehospital triage should therefore be considered on a regional level.
    MeSH term(s) Humans ; Triage ; Brain Ischemia/diagnosis ; Emergency Medical Services ; Prospective Studies ; Stroke/therapy ; Stroke/drug therapy ; Fibrinolytic Agents/therapeutic use ; Thrombolytic Therapy ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents
    Language English
    Publishing date 2023-06-20
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1461751-1
    ISSN 1545-0066 ; 1090-3127
    ISSN (online) 1545-0066
    ISSN 1090-3127
    DOI 10.1080/10903127.2023.2215859
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 4762: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Comparison of Prehospital Assessment by Paramedics and In-Hospital Assessment by Physicians in Suspected Stroke Patients: Results From 2 Prospective Cohort Studies.

    Dekker, Luuk / Daems, Jasper D / Duvekot, Martijne H C / Nguyen, T Truc My / Venema, Esmee / van Es, Adriaan C G M / Rozeman, Anouk D / Moudrous, Walid / Dorresteijn, Kirsten R I S / Hensen, Jan-Hein J / Bosch, Jan / van Zwet, Erik W / de Schryver, Els L L M / Kloos, Loet M H / de Laat, Karlijn F / Aerden, Leo A M / van den Wijngaard, Ido R / Dippel, Diederik W J / Kerkhoff, Henk /
    Wermer, Marieke J H / Roozenbeek, Bob / Kruyt, Nyika D

    Stroke

    2023  Volume 54, Issue 9, Page(s) 2279–2285

    Abstract: Background: It is unknown if ambulance paramedics adequately assess neurological deficits used for prehospital stroke scales to detect anterior large-vessel occlusions. We aimed to compare prehospital assessment of these stroke-related deficits by ... ...

    Abstract Background: It is unknown if ambulance paramedics adequately assess neurological deficits used for prehospital stroke scales to detect anterior large-vessel occlusions. We aimed to compare prehospital assessment of these stroke-related deficits by paramedics with in-hospital assessment by physicians.
    Methods: We used data from 2 prospective cohort studies: the LPSS (Leiden Prehospital Stroke Study) and PRESTO study (Prehospital Triage of Patients With Suspected Stroke). In both studies, paramedics scored 9 neurological deficits in stroke code patients in the field. Trained physicians scored the National Institutes of Health Stroke Scale (NIHSS) at hospital presentation. Patients with transient ischemic attack were excluded because of the transient nature of symptoms. Spearman rank correlation coefficient (r
    Results: We included 2850 stroke code patients. Of these, 1528 had ischemic stroke, 243 intracranial hemorrhage, and 1079 stroke mimics. Correlation between the total prehospital assessment score and NIHSS score was strong (r
    Conclusions: The overall prehospital assessment of stroke code patients correlates strongly with in-hospital assessment. Prehospital assessment of neglect, abnormal speech, and gaze deviation differed most from in-hospital assessment. Focused training on these deficits may improve prehospital triage.
    MeSH term(s) Humans ; Emergency Medical Services/methods ; Paramedics ; Prospective Studies ; Stroke ; Triage/methods ; Hospitals ; Physicians
    Language English
    Publishing date 2023-07-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.123.042644
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 448: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Comparison of Prehospital Scales for Predicting Large Anterior Vessel Occlusion in the Ambulance Setting.

    Nguyen, T Truc My / van den Wijngaard, Ido R / Bosch, Jan / van Belle, Eduard / van Zwet, Erik W / Dofferhoff-Vermeulen, Tamara / Duijndam, Dion / Koster, Gaia T / de Schryver, Els L L M / Kloos, Loet M H / de Laat, Karlijn F / Aerden, Leo A M / Zylicz, Stas A / Wermer, Marieke J H / Kruyt, Nyika D

    JAMA neurology

    2020  Volume 78, Issue 2, Page(s) 157–164

    Abstract: Importance: The efficacy of endovascular thrombectomy (EVT) for symptomatic large anterior vessel occlusion (sLAVO) sharply decreases with time. Because EVT is restricted to comprehensive stroke centers, prehospital triage of patients with acute stroke ... ...

    Abstract Importance: The efficacy of endovascular thrombectomy (EVT) for symptomatic large anterior vessel occlusion (sLAVO) sharply decreases with time. Because EVT is restricted to comprehensive stroke centers, prehospital triage of patients with acute stroke codes for sLAVO is crucial, and although several prediction scales are already in use, external validation, head-to-head comparison, and feasibility data are lacking.
    Objective: To conduct external validation and head-to-head comparisons of 7 sLAVO prediction scales in the emergency medical service (EMS) setting and to assess scale feasibility by EMS paramedics.
    Design, setting, and participants: This prospective cohort study was conducted between July 2018 and October 2019 in a large urban center in the Netherlands with a population of approximately 2 million people and included 2 EMSs, 3 comprehensive stroke centers, and 4 primary stroke centers. Participants were consecutive patients aged 18 years or older for whom an EMS-initiated acute stroke code was activated. Of 2812 acute stroke codes, 805 (28.6%) were excluded, because no application was used or no clinical data were available, leaving 2007 patients included in the analyses.
    Exposures: Applications with clinical observations filled in by EMS paramedics for each acute stroke code enabling reconstruction of the following 7 prediction scales: Los Angeles Motor Scale (LAMS); Rapid Arterial Occlusion Evaluation (RACE); Cincinnati Stroke Triage Assessment Tool; Prehospital Acute Stroke Severity (PASS); gaze-face-arm-speech-time; Field Assessment Stroke Triage for Emergency Destination; and gaze, facial asymmetry, level of consciousness, extinction/inattention.
    Main outcomes and measures: Planned primary and secondary outcomes were sLAVO and feasibility rates (ie, the proportion of acute stroke codes for which the prehospital scale could be reconstructed). Predictive performance measures included accuracy, sensitivity, specificity, the Youden index, and predictive values.
    Results: Of 2007 patients who received acute stroke codes (mean [SD] age, 71.1 [14.9] years; 1021 [50.9%] male), 158 (7.9%) had sLAVO. Accuracy of the scales ranged from 0.79 to 0.89, with LAMS and RACE scales yielding the highest scores. Sensitivity of the scales ranged from 38% to 62%, and specificity from 80% to 93%. Scale feasibility rates ranged from 78% to 88%, with the highest rate for the PASS scale.
    Conclusions and relevance: This study found that all 7 prediction scales had good accuracy, high specificity, and low sensitivity, with LAMS and RACE being the highest scoring scales. Feasibility rates ranged between 78% and 88% and should be taken into account before implementing a scale.
    MeSH term(s) Aged ; Aged, 80 and over ; Ambulances/standards ; Cerebrovascular Disorders/diagnosis ; Cerebrovascular Disorders/therapy ; Cohort Studies ; Emergency Medical Services/methods ; Emergency Medical Services/standards ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Severity of Illness Index
    Language English
    Publishing date 2020-10-17
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2020.4418
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ui II Zs.191: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top