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Prehospital Triage System Improves Stroke Care

Field tests for suspected stroke patients communicated to the hospital; cuts time for endovascular thrombectomy

MONDAY, April 13, 2020 (HealthDay News) — A new pretransport triage system improves stroke care, according to a study published online April 6 in JAMA Neurology.

Michael V. Mazya, M.D., Ph.D., from Karolinska University Hospital in Stockholm, and colleagues evaluated the predictive performance of the newly implemented Stockholm Stroke Triage System for large-artery occlusion (LAO) stroke and endovascular thrombectomy (EVT) initiation.

The researchers identified 2,905 patients with code-stroke transports (49 percent women), of whom 11 percent had ipsilateral arm and leg teleconsultation-positive results and were triaged for direct transport to a comprehensive stroke center. For predicting LAO stroke, the triage system had a positive predictive value of 41 percent and a negative predictive value of 93 percent. For EVT initiation the positive predictive value was 26 percent and the negative predictive value was 99 percent. EVT was performed in 26 and 1.4 percent of patients with triage-positive and triage-negative results, respectively. The median onset-to-puncture time for EVT cases with a known onset time was 137 minutes compared with 206 minutes in the previous year.

“The Stockholm Stroke Triage System, which combines symptom severity and teleconsultation, results in markedly faster EVT delivery without delaying intravenous thrombolysis,” the authors write.

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