Factors related to use of emergency medical services in patients with acute stroke

Abstract

Objective To examine the availability of emergency medical services(EMS) for patients with acute stroke and to investigate influential factors affecting the preference of patients’to EMS. Methods Consecutive information of patients with acute stroke who presented to the emergency department of Zhongnan Hospital of Wuhan University from June 1, 2014 to December 31, 2015 were analyzed. Gender, age of patients, transport modality, risk factors in cerebrovascular diseases, initial symptoms, stroke types, onset and admission time were included to make analysis in retrospective study. The participants were divided into two groups based on the preference of patients, namely EMS group and self-transport group. Wilcoxon rank sum test or Chi-squared test was used to statistical analysis as appropriate. A multiple binary logistic regression was used to determine the relationship between various patient-related factors with probability whether patients chose EMS or not. Results Among the 240 patients, only 29.2%of them asked for the EMS at the onset of symptoms (EMS group, n=70), and the rest patients called for other services(self-transport group, n=170). Logistic regression analysis revealed that the patients with the symptom of altered consciousness or convulsion (95%CI: 0.107-0.403, OR=0.208, P<0.01) were more likely to use EMS. The time consumed from onset to visit of patients with acute stroke to emergency physician was significantly shorter in EMS group (M, 60 min vs.180 min, P<0.01). Conclusion The symptom of altered consciousness or convulsion was the independent factor to determine whether patients with acute stroke preferred EMS or not. Key words: Stroke; Cerebral infarction; Emergency medical services; Pre-hospital transport