Factors delaying hospital admission after stroke in Leicestershire.

Harper, GD; Haigh, R A; Potter, JF; Castleden, C. M.

doi:10.1161/01.str.23.6.835

Cited by 90 publications

(86 citation statements)

References 15 publications

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“…Dos 44 procedimentos invasivos mais frequentemente realizados, 17 (38,6%) corresponderam à sondagem gástrica ou enteral, 13 (29,5%) necessitaram de sondagem vesical de demora, 9 (20,5%) necessitaram de entubação endotraqueal, 5 (11,4%) ciente com AVCI é o tempo de apresentação ao serviço de emergência desde o início dos sintomas, quando excede 3 horas 12,13 . Diante desta janela de tempo o Food and Drug Administration (FDA) aprovou em junho de 1996 o uso do rt-PA, baseado nos resultados do National Institute of Neurologic Disorders (NINDS), que analisou os passos sequenciais a serem seguidos para um atendimento rápido e sistematizado, obedecendo à janela terapêutica, entre eles: o reconhecimento dos sinais e sintomas e ação pelo paciente ou conhecido, acesso ao cuidado, transporte ao hospital com TC, diagnóstico rápido no departamento de emergência, interpretação da TC, crité-rios de inclusão e tratamento 8 .…”

Section: Resultsunclassified

“…Comparativamente, houve redução aproximada de 8 e 3 horas, respectivamente, mostrando que a população tem chegado mais precocemente ao hospital e, principalmente sugerindo que os médicos clínicos, neurologistas, enfermeiros, radiologistas e outros profissionais envolvidos no atendimento, têm reconhecido o evento como emergência médica. Segundo a literatura, diversos são os fatores que contribuem para a apresentação precoce do paciente ao serviço de emergência: a presença de fatores de risco, tipos de sinais e sintomas, meio de transporte utilizado, nível de escolaridade, local do acontecimento e a circunstância de indivíduos que vivem sozinhos 7,[12][13][14] . Em nosso estudo, como esperado, verificamos que o principal fator de risco é a hipertensão arterial, seguida por doenças cardíacas, AVC prévio, tabagismo e diabetes mellitus, distribuídos sem diferenças quanto ao tempo.…”

Section: Discussionunclassified

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Paciente com acidente vascular cerebral isquêmico já é atendido com mais rapidez no Hospital São Paulo

Yamashita

Fukujima

Granitoff

et al. 2004

Arq. Neuro-Psiquiatr.

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, Gilmar Fernandes do Prado 2RESUMO -Foram caracterizados os pacientes com diagnóstico de acidente vascular cerebral (AVC) isquêmico internados por período superior a 24 horas. Investigamos os fatores que influenciam a chegada precoce ou tardia do paciente ao pronto socorro, o intervalo de tempo entre a chegada e a realização de tomografia computadorizada (TC), os fatores que influenciam na permanência destes pacientes no hospital e o seu destino. Concluímos que a população atendida pelo Hospital São Paulo tem chegado ao hospital mais precocemente que há 3 anos (47% chegaram nas primeiras 3 horas de instalação) e que o fluxo interno do paciente ficou muito mais rápido, uma vez que o AVC é considerado emergência médica pela equipe de saúde. As principais complicações apresentadas pelos pacientes foram infecciosas e nos direcionam à proposta de implementação de protocolos para a melhoria aos cuidados que devem ser prestados pelos profissionais de saúde. PALAVRAS-CHAVE: acidente vascular cerebral, isquemia cerebral, complicações. Patients with ischemic stroke are taken care quickly in São Paulo HospitalABSTRACT -We observed inpatients with the diagnosis of ischemic stroke hospitalized at least 24 hours. We investigated the reasons for early or late arrival to the Emergency Room, the time span from arrival to computed tomography (CT) scanning, factors associated to hospitalization time, and patients outcome. We concluded that people who are cared for by São Paulo Hospital now get to the hospital sooner than they did 3 years ago (47% arrived in 3 hours or less) and that the patient flow inside the hospital became much faster, once any stroke patient is considered now a medical emergency by the hospital staff. Infections were the main complications presented by our patients, which is leading us to optimize protocols to improve emergency care by all the staff.

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Section: Resultsunclassified

Section: Discussionunclassified

Paciente com acidente vascular cerebral isquêmico já é atendido com mais rapidez no Hospital São Paulo

Yamashita

Fukujima

Granitoff

et al. 2004

Arq. Neuro-Psiquiatr.

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“…Prior studies of stroke presentation times have failed to identify living in a rural setting as an independent predictor of a delayed hospital presentation. 53 Numerous studies of transportation practices of trauma patients have been conducted in rural settings, and all have shown that rapid access to EMS is both possible and beneficial. 54,55 Although we appreciate that the use of EMS for the rapid transportation of patients with acute stroke in a rural setting may present some logistical challenges, the experience with trauma patients suggests that these obstacles can be overcome.…”

Section: Emergency Medical Servicesmentioning

confidence: 99%

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

Alberts

Latchaw

Jagoda

et al. 2011

Stroke

195

167

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for the Brain Attack CoalitionBackground and Purpose-The formation and certification of Primary Stroke Centers has progressed rapidly since the Brain Attack Coalition's original recommendations in 2000. The purpose of this article is to revise and update our recommendations for Primary Stroke Centers to reflect the latest data and experience. Methods-We conducted a literature review using MEDLINE and PubMed from March 2000 to January 2011. The review focused on studies that were relevant for acute stroke diagnosis, treatment, and care. Original references as well as meta-analyses and other care guidelines were also reviewed and included if found to be valid and relevant. Levels of evidence were added to reflect current guideline development practices. Results-Based on the literature review and experience at Primary Stroke Centers, the importance of some elements has been further strengthened, and several new areas have been added. These include (1) the importance of acute stroke teams; (2) the importance of Stroke Units with telemetry monitoring; (3) performance of brain imaging with MRI and diffusion-weighted sequences; (4) assessment of cerebral vasculature with MR angiography or CT angiography; (5) cardiac imaging; (6) early initiation of rehabilitation therapies; and (7) certification by an independent body, including a site visit and disease performance measures. Conclusions-Based on the evidence, several elements of Primary Stroke Centers are particularly important for improving the care of patients with an acute stroke. Additional elements focus on imaging of the brain, the cerebral vasculature, and the heart. These new elements may improve the care and outcomes for patients with stroke cared for at a Primary Stroke Center. (Stroke. 2011;42:2651-2665.)

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“…4 (3) 45 1 (83) 40('t) 90(l 7) 223 (41) 2e (s) 26 (5) 66 ( I 2) 64 (12) e (2) 6 ( 1) s4 (e) 196 (8s) 28 (r2) 7e (34) 67 (29) 1e (8) 6 (3) s (2) 24 (10) 4 (2) 4 (2) 8 (3) 2 (4) 3 (6) 181 (75) 2s0 (88) 2s1s (68) 33 (14) 7 (3) 286(8) 18 (7) 17 (6) s24 (r4) 68 (28) rr8 (42) 1 186(32) 18 (7) e(3) r 85 (5) 28 (1 2) 52(1 8) 1s2 (4) 21 (9) 40 (14) 3s7 (r0) se (24) 26(e) 350(e) 4 (2) 3(1) 63(2) 4 (2) 3(r ) 36 (r ) 30 (12) 21(10) 922(24) values are number ( percentage ) 1(2) 46 (88) 4 (8) 1 (2) t82(e) 1 171(s7) 33 (2) 479 (23) 88 (4) r 04 …”

Section: (S)mentioning

confidence: 99%

Pattern of hospitalized-stroke patients in ASEAN countries an ASNA stroke epidemiological study

Misbach¹

2001

Med J Indones

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AbstrakUntuk lebih memahami gambaran karakteristik, waktu tiba, pola klinis, faktor risiko, jenis stroke, Iama rawat, dan status keluaran dari pasien stroke akut di negara-negara ASEAN 44 participating hospitals in this study ie Brunei (n=53), Indonesia (n=2065), Malaysia (n=300),Philippines (n=545),Singapore (n=2j2),Thailand (n=244) and Vietnam (n=284), the mean age was 59.0 + 13,8 years 16 Vo of patients were younger than 45 years and 37 Vo of patients were older than 65 years. There were no significant differences in age at onset among stroke subjects except in Vietnam (younger) and Singapore (older).The sex distribution showed a slight higher prevalence of women in Singapore and in the age group > 64 years. The mean adrnission time was 41.5 + 87.0 hours, 19Va of patients were admitted within 3 hours, 29Vo within 6 hours and 66Vo more than 6 hours (delayed admission) especially in Malaysia and Singapore (80Vo and 77Vo respectively). Motor disability was the most prevalent clinical feature in all counties and carotid bruit was the rarest (IVo).Hypertension was the most comnnon riskfactor (68Vù in all countries, followed by TIA (35Vo), smoking, diabetes mellitus, ischnemic heart disease and hypercholesterolemia. CT scan was performed on 76 Vo of subjects. The diagnostic classification \eas non lacunar anterior circulation (32Vo), lacwnar infarction (14Vo), hemonhagic stroke (26Eù, SAH (4Eo).Mean length of stay was I1.4 + I L8 days. Most of the patients discharged from the hospiîal were alive improved (57Vo) and mean death rate was 22 Vo, highest in Thailand (45Vo) and lowest in Brunei (8Vo). This hospital based stroke data showed the recent characteristics of stroke pattern in seven ASEAN member countries and it wilL be very important data for heatth policy maker in these countries and for further cooperative researches in the future. (Med J Indones 200I;

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Factors delaying hospital admission after stroke in Leicestershire.

Cited by 90 publications

References 15 publications

Paciente com acidente vascular cerebral isquêmico já é atendido com mais rapidez no Hospital São Paulo

Paciente com acidente vascular cerebral isquêmico já é atendido com mais rapidez no Hospital São Paulo

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

Pattern of hospitalized-stroke patients in ASEAN countries an ASNA stroke epidemiological study

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