Enquête observationnelle : les accidents vasculaires cérébraux aux urgences en région Centre (étude AVC Centre)

Bonnaud, I.; Giraudeau, Bruno; Julié, V.; Soulat, Louis; Beaufils, J.; Brock, Thaís; Goralski, M.; Perrotin, D.

doi:10.1016/s0035-3787(05)85037-4

Cited by 6 publications

(1 citation statement)

References 12 publications

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“…On the contrary, even if the geographical accessibility to the ERs or stroke units varies greatly in this French region, the location of the patient at symptom onset was not found as associated with a delayed management. Overall, the healthcare pathway for patients with a stroke suspicion seemed to improve in the region, because 48% of patients with a suspicion of stroke were admitted in the first hospital within 3 h after the symptom onset, as compared to 40% in 2002 [18]. This result is coherent with the literature, indicating a '6.0% annual decline in h/year for the prehospital delay, defined from symptom onset to emergency department' [10].…”

Section: Discussionsupporting

confidence: 74%

Factors associated with delayed revascularization in patients with ischemic stroke: a prospective study in one French region

Laurent

Bonnaud²,

Gaudron³

et al. 2021

European Journal of Emergency Medicine

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Background and importanceOptimizing the care pathway of stroke is crucial for the revascularization of ischemic stroke.Objectives to identify factors associated with (1) a time interval over 4 h between the symptom onset and cerebral imaging in suspected stroke patients and (2) the absence of revascularization in patients with ischemic stroke. Design, settings and participantsPatients over 18 years old with a suspected stroke admitted in 22 emergency rooms or stroke units in one French region between 1 March 2019 and 30 April 2019 were prospectively included by filling a dedicated form. Outcome measures and analysisFactors associated with the previously mentioned outcome measures were identified using logistic regression models. Main resultsIn total 991 patients were included; 537 patients (64% of 845 with available time intervals) were admitted more than 4 h after symptom onset. Three predictors were identified: not calling emergency medical services (EMS) [odds-ratio (OR) 5.2; 95% confidence interval (3.4-8.1)], a preexisting autonomy loss [2.0 (1.3-2.9)] and atypical clinical presentation [2.0 (1.3-3.1)]. A total of 385 patients had an ischemic stroke of whom 93 underwent a revascularization procedure (24%). The same three predictors were associated with the absence of revascularization procedure, added to an initial admission in a hospital without stroke unit [3.1 (1.1-8.6)]. ConclusionThis study shows that efforts to organize the care chain for stroke need to be intensified in the region to reduce treatment time intervals, which could include information campaigns focused on the impact of EMS call and the clinical presentation recognition.

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Section: Discussionsupporting

confidence: 74%