Unknown

Dataset Information

0

Prehospital Stroke Management Optimized by Use of Clinical Scoring vs Mobile Stroke Unit for Triage of Patients With Stroke: A Randomized Clinical Trial.


ABSTRACT: Importance:Transferring patients with large-vessel occlusion (LVO) or intracranial hemorrhage (ICH) to hospitals not providing interventional treatment options is an unresolved medical problem. Objective:To determine how optimized prehospital management (OPM) based on use of the Los Angeles Motor Scale (LAMS) compares with management in a Mobile Stroke Unit (MSU) in accurately triaging patients to the appropriate hospital with (comprehensive stroke center [CSC]) or without (primary stroke center [PSC]) interventional treatment. Design, Setting, and Participants:In this randomized multicenter trial with 3-month follow-up, patients were assigned week-wise to one of the pathways between June 15, 2015, and November 15, 2017, in 2 regions of Saarland, Germany; 708 of 824 suspected stroke patients did not meet inclusion criteria, resulting in a study population of 116 adult patients. Interventions:Patients received either OPM based on a standard operating procedure that included the use of the LAMS (cut point ?4) or management in an MSU (an ambulance with vascular imaging, point-of-care laboratory, and telecommunication capabilities). Main Outcomes and Measures:The primary end point was the proportion of patients accurately triaged to either CSCs (LVO, ICH) or PSCs (others). Results:A predefined interim analysis was performed after 116 patients of the planned 232 patients had been enrolled. Of these, 53 were included in the OPM group (67.9% women; mean [SD] age, 74 [11] years) and 63 in the MSU group (57.1% women; mean [SD] age, 75 [11] years). The primary end point, an accurate triage decision, was reached for 37 of 53 patients (69.8%) in the OPM group and for 63 of 63 patients (100%) in the MSU group (difference, 30.2%; 95% CI, 17.8%-42.5%; P?

SUBMITTER: Helwig SA 

PROVIDER: S-EPMC6724153 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

altmetric image

Publications

Prehospital Stroke Management Optimized by Use of Clinical Scoring vs Mobile Stroke Unit for Triage of Patients With Stroke: A Randomized Clinical Trial.

Helwig Stefan A SA   Ragoschke-Schumm Andreas A   Schwindling Lenka L   Kettner Michael M   Roumia Safwan S   Kulikovski Johann J   Keller Isabel I   Manitz Matthias M   Martens Daniel D   Grün Daniel D   Walter Silke S   Lesmeister Martin M   Ewen Kira K   Brand Jannik J   Fousse Mathias M   Kauffmann Jil J   Zimmer Valerie C VC   Mathur Shrey S   Bertsch Thomas T   Guldner Jürgen J   Magull-Seltenreich Achim A   Binder Andreas A   Spüntrup Elmar E   Chatzikonstantinou Anastasios A   Adam Oliver O   Kronfeld Kai K   Liu Yang Y   Ruckes Christian C   Schumacher Helmut H   Grunwald Iris Q IQ   Yilmaz Umut U   Schlechtriemen Thomas T   Reith Wolfgang W   Fassbender Klaus K  

JAMA neurology 20191201 12


<h4>Importance</h4>Transferring patients with large-vessel occlusion (LVO) or intracranial hemorrhage (ICH) to hospitals not providing interventional treatment options is an unresolved medical problem.<h4>Objective</h4>To determine how optimized prehospital management (OPM) based on use of the Los Angeles Motor Scale (LAMS) compares with management in a Mobile Stroke Unit (MSU) in accurately triaging patients to the appropriate hospital with (comprehensive stroke center [CSC]) or without (primar  ...[more]

Similar Datasets

| S-EPMC8921783 | biostudies-literature
| S-EPMC6205725 | biostudies-literature
| S-EPMC7136864 | biostudies-literature
| S-EPMC6435279 | biostudies-literature
| S-EPMC7650132 | biostudies-literature
| S-EPMC6407433 | biostudies-literature
| S-EPMC8822443 | biostudies-literature
| S-EPMC11340938 | biostudies-literature
| S-EPMC6615792 | biostudies-literature
| S-EPMC6645624 | biostudies-literature