Prognostic effect of EMS combined with intravenous thrombolysis on the patients with acute ischemic stroke and the analysis of delayed factors in hospital
Li Baiyan
Mi Xiaolu
Zhu Baoyue
Wang Weizhan
Xiao Qingmian
Abstract：Objective To investigate the effect of emergency medical service(EMS)combined with intravenous thrombolysis on the prognosis of patients with acute ischemic stroke(AIS)and to analyze the main links of in-hospital delay phenomenon.Methods A retrospective research method was adopted.200 AIS patients who received EMS combined with intravenous thrombolysis treatment in the emergency department from May 2019 to October 2023 were selected as the research group.Another 200 AIS patients who received traditional emergency thrombolysis from January 2016 to April 2019 were selected as the control group.The length of hospital stay,modified Rankin scale(mRS),the changes in door-to-needle time(DNT),national institutes of health stroke scale(NIHSS),the probability of adverse prognosis and the changes in quality of life between the two groups were compared.The time of hospital diagnosis and treatment in two different admission methods was compared.Results The length of hospital stay,mRS and DNT of the research group were all lower than those of the control group(P＜0.05),the NIHSS of the research group after treatment at the 2 d and 4 d were lower than those control group(P＜0.05),and the probability of recurrent cerebral hemorrhage,recurrent cerebral infarction and death were lower in the research group than in the control group(P＜0.05).After treatment,the quality of life in the research group was higher than that in the control group(P＜0.05).The median time of 23 min for"completion of head CT scan to obtaining CT report"of patients admitted by EMS was higher than the recommended 20 min(P＜0.05).The median time of 25 min for"obtaining head CT report-initiating thrombolytic therapy"was higher than the recommended 15 min(P＜0.001).The median time of in-hospital diagnosis and treatment in the patients treated by EMS was 112 min,which was shorter than 120 min in the patients treated without EMS(P＜0.05).Conclusions EMS combined with thrombolytic therapy has significantly therapeutic effects,and the delay of treatment in hospital is serious.The link from"obtaining head CT report"to"starting thrombolytic therapy"is the main link that causes the delay in hospital.
Keywords：Acute ischemic strokeHospital delayDoor-to-needle timeThrombolysisNational institutes of health stroke scale
Publication Date：2025-03-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 245-250 )