Potential Impact of C-STAT for Prehospital Stroke Triage up to 24 Hours on a Regional Stroke System.
In: Prehospital Emergency Care, Jg. 24 (2020-07-01), Heft 4, S. 500-504
academicJournal
Zugriff:
Background and Purpose: Thrombectomy for large vessel occlusion acute ischemic stroke (AIS-LVO) may benefit patients up to 24 hour since last known normal (LKN). Prehospital tools, like the Cincinnati Stroke Triage Assessment Tool (C-STAT), are used to select hospital destination for suspected AIS-LVO patients. The objective of this study was to estimate the potential impact of the expanded thrombectomy time window on suspected AIS-LVO cases transported to the regional comprehensive stroke center (CSC). Methods: From June to November 2015, C-STAT was performed by prehospital providers following a positive prehospital Cincinnati Prehospital Stroke Scale (CPSS) stroke screen in suspected stroke/TIA patients. There was no preferential triage based on C-STAT results. Final diagnoses, including the presence of AIS-LVO was ascertained via medical record review. Impact of positive C-STAT cases on CSC volumes was estimated for up to 24 hours since LKN. Results: Of 158 patients with prehospital suspicion for stroke/TIA, 105 were CPSS positive within 24 hours of onset and had complete C-STAT and clinical data available for analysis. Forty-six percent (17/37) of C-STAT + were non-strokes. C-STAT sensitivity and specificity for LVO were 71% (95% CI 36–92) and 67% (95% CI 58–80), respectively. C-STAT triage would increase transport of prehospital suspected stroke cases to the CSC by 11% (12/105) within six hours and 21% (22/105) within 24 hours. Of 37 C-STAT + patients, only 5 (13.5%) had LVO as final diagnosis. Conclusions: Preferential triage of prehospital suspected stroke patients using C-STAT would increase the number of patients transported to the CSC by 11% within six hours and an additional 10% from six to 24 hours. For every patient with LVO as final diagnosis, approximately an additional 6 non-LVO patients would be triaged to a CSC. [ABSTRACT FROM AUTHOR]
Copyright of Prehospital Emergency Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Potential Impact of C-STAT for Prehospital Stroke Triage up to 24 Hours on a Regional Stroke System.
|
---|---|
Autor/in / Beteiligte Person: | Li, James L. ; McMullan, Jason T. ; Sucharew, Heidi ; Broderick, Joseph P. ; Katz, Brian ; Schmit, Pamela ; Adeoye, Opeolu |
Zeitschrift: | Prehospital Emergency Care, Jg. 24 (2020-07-01), Heft 4, S. 500-504 |
Veröffentlichung: | 2020 |
Medientyp: | academicJournal |
ISSN: | 1090-3127 (print) |
DOI: | 10.1080/10903127.2019.1676343 |
Schlagwort: |
|
Sonstiges: |
|