上海某院EMS转运急性缺血性脑卒中患者院前延误的回顾性研究
A Retrospective Study of Pre-Hospital Delay in Initiating Emergency Medical Service for Transport of Acute Ischemic Stroke Patients in a Hospital of Shanghai
石柳娴 1葛英军 1陈守畅 1沈国荣 1施宇一 1李响 2姜志鹏1
作者信息
- 1. 上海市闵行区医疗急救中心急救科,上海 201199
- 2. 复旦大学附属闵行医院重症医学科,上海 201199
- 折叠
摘要
目的 探究启动EMS(emergency medical service,紧急医疗服务)转运的急性缺血性脑卒中患者院前延误的影响因素,为急性缺血性脑卒中患者减少延误提高策略.方法 对132例启动EMS的急性缺血性脑卒中患者进行相关影响因素分析,包括年龄、性别、呼救时天气情况、脑卒中知识认知度,首发症状等,分为延误组(n=29)和及时组(n=103),通过多因素Logistics回归分析确定造成院前延误的影响因素.结果 两组患者在不同天气情况、卒中知识认知度、首发症状上存在差异(P＜0.05).多因素Logistics回归分析显示天气情况(OR=0.581,95％CI:0.358～0.943),卒中知识认知度(OR=0.238,95％CI:0.098～0.578)及首发症状为意识障碍(OR=0.076,95％CI:0.008～0.717)是减少院前延误的独立影响因素(P＜0.05).结论 较高卒中知识认知度、首发症状有意识障碍、天气情况良好有利于减少启动EMS转运的急性缺血性脑卒中患者的院前延误.因此,加强公众卒中知识普及培训,提高公众卒中意识,尽快启动EMS系统,可减少院前延误,改善患者预后.
Abstract
Objective To investigate the factors of pre-hospital delay in the initiation of emergency medical service(EMS)for transport of acute ischemic stroke patients,to provide strategies for reducing such delay for these patients.Methods A total of 132 acute ischemic stroke patients who were transported through EMS were analyzed for relevant influencing factors,including age,gender,weather conditions at the time of calling for EMS,how well they know about stroke,and onset symptoms.They were divided into the delayed group(n=29)and the timely group(n=103).The factors of pre-hospital delay were analyzed by multivariate logistic regression.Results There were differences between the two groups in weather conditions,how well they know a-bout stroke,and onset symptoms(P＜0.05).Multivariate logistic regression analysis showed that weather conditions(OR=0.581,95％CI:0.358-0.943),knowledge of stroke(OR=0.238,95％CI:0.098-0.578)and onset symptom of impaired consciousness(OR=0.076,95％CI:0.008-0.717)were the independent factors in reducing such delay(P＜0.05).Conclusion More knowledge of stroke,onset symptom of impaired consciousness,and good weather conditions can reduce the risk of pre-hospital delay in the initiation of EMS for transport of acute ischemic stroke patients.Therefore,improving the public knowledge of stroke and strengthening training,in-creasing the public awareness of stroke and timely activating the EMS system can reduce the risk of delay and improve patient prognosis.
关键词
急性缺血性脑卒中/启动EMS转运/院前延误/影响因素Key words
Acute ischemic stroke/Initiation of EMS for transport/Pre-hospital delay/Influen-cing factors引用本文复制引用
基金项目
上海市闵行区卫生健康委员会临床研究类科研课题项目(2021MW41)
出版年
2024
NETL
NSTL
万方数据