Benefits of Prehospital Notification for Stroke Patients

Early identification and management of acute stroke are critical for improving outcomes. To examine the effects of advance notification of the arrival of stroke patients, researchers retrospectively analyzed data for 118 patients with acute stroke who were transported by emergency medical services directly from the scene to a single tertiary care emergency department within 6 hours of symptom onset during a 16-month period.

EMS staff provided advance notification to ED staff for 44 patients. No significant differences in age, sex, stroke history, or median National Institutes of Health Stroke Scale scores were noted between patients for whom prehospital notification was and was not given. Prehospital notification was associated with significantly shorter door-to-computed tomography (CT) time than no prehospital notification (median time, 40 vs. 47 minutes). In multivariable linear regression modeling, prehospital notification reduced door-to-CT time by 23%. Nine patients for whom prehospital notification was given and none for whom notification was not given had prolonged door-to-CT times (2–5 hours). All patients were evaluated by a vascular neurologist. Overall, 29% of patients received thrombolytic therapy (intravenous tissue plasminogen activator [TPA] in 20; IV TPA followed by intra-arterial thrombolysis in 12; and intra-arterial thrombolysis alone in 2). Patients who arrived at the ED after prehospital notification were twice as likely as those who arrived without advance notice to receive thrombolytic therapy (42% vs. 21%).