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Implementation of a Prehospital Stroke Triage System Using Symptom Severity and Teleconsultation in the Stockholm Stroke Triage Study

Implementation of a Prehospital Stroke Triage System Using Symptom Severity and Teleconsultation... Key PointsQuestionWhat was the predictive performance for large artery occlusion stroke and the association with onset-to-delivery times for endovascular and intravenous recanalization therapies during the first year following implementation of the prehospital Stockholm Stroke Triage System that combined motor symptom severity with ambulance-to-hospital teleconsultation? FindingsIn this cohort study of 2905 patients undergoing code-stroke ambulance transport within the Stockholm region (Sweden), the new triage system had an overall accuracy in predicting large-artery occlusion stroke of 87% (positive predictive value, 41%; negative predictive value, 93%). The median onset-to-puncture time for thrombectomy was 137 minutes vs 206 minutes in the previous year, while onset-to-needle time for intravenous thrombolysis was unchanged at a median of 115 minutes. MeaningCombining a symptom-based prehospital triage algorithm with ambulance-to-hospital teleconsultation may result in markedly reduced delivery times for thrombectomy without delaying intravenous thrombolysis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Neurology American Medical Association

Implementation of a Prehospital Stroke Triage System Using Symptom Severity and Teleconsultation in the Stockholm Stroke Triage Study

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References (37)

Publisher
American Medical Association
Copyright
Copyright 2020 American Medical Association. All Rights Reserved.
ISSN
2168-6149
eISSN
2168-6157
DOI
10.1001/jamaneurol.2020.0319
Publisher site
See Article on Publisher Site

Abstract

Key PointsQuestionWhat was the predictive performance for large artery occlusion stroke and the association with onset-to-delivery times for endovascular and intravenous recanalization therapies during the first year following implementation of the prehospital Stockholm Stroke Triage System that combined motor symptom severity with ambulance-to-hospital teleconsultation? FindingsIn this cohort study of 2905 patients undergoing code-stroke ambulance transport within the Stockholm region (Sweden), the new triage system had an overall accuracy in predicting large-artery occlusion stroke of 87% (positive predictive value, 41%; negative predictive value, 93%). The median onset-to-puncture time for thrombectomy was 137 minutes vs 206 minutes in the previous year, while onset-to-needle time for intravenous thrombolysis was unchanged at a median of 115 minutes. MeaningCombining a symptom-based prehospital triage algorithm with ambulance-to-hospital teleconsultation may result in markedly reduced delivery times for thrombectomy without delaying intravenous thrombolysis.

Journal

JAMA NeurologyAmerican Medical Association

Published: Jun 6, 2020

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