Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26018
Title: Factors associated with arrival by ambulance for patients with stroke: a multicentre, national data linkage study.
Austin Authors: Eliakundu, Amminadab L;Cadilhac, Dominique A;Kim, Joosup;Andrew, Nadine E;Bladin, Christopher F;Grimley, Rohan;Dewey, Helen M;Donnan, Geoffrey A ;Hill, Kelvin;Levi, Christopher R;Middleton, Sandy;Anderson, Craig S;Lannin, Natasha A;Kilkenny, Monique F
Affiliation: Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia
Eastern Health Clinical School, Box Hill, Victoria, Australia
Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health
The George Institute for Global Health and Faculty of Medicine, University of New South Wales, New South Wales, Australia
Ambulance Victoria, Doncaster, Victoria, Australia
Acute Stroke Services, John Hunter Hospital, Newcastle, New South Wales, Australia
Sunshine Coast Clinical School, Griffith University, Birtinya, Queensland, Australia
Stroke Foundation, Victoria, Australia
Alfred Health, Melbourne, Australia
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University..
Issue Date: Sep-2021
Date: 2021-02-25
Publication information: Australasian Emergency Care 2021; 24(3): 167-173
Abstract: Hospital arrival via ambulance influences treatment of acute stroke. We aimed to determine the factors associated with use of ambulance and access to evidence-based care among patients with stroke. Patients with first-ever strokes from the Australian Stroke Clinical Registry (2010-2013) were linked with administrative data (emergency, hospital admissions). Multilevel, multivariable regression models were used to determine patient, clinical and system factors associated with arrival by ambulance. Among the 6,262 patients with first-ever stroke, 4,737 (76%) arrived by ambulance (52% male; 80% ischaemic). Patients who were older, frailer, with comorbidities or were unable to walk on admission (stroke severity) were more likely to arrive by ambulance to hospital. Compared to those using other means of transport, those who used ambulances arrived to hospital sooner after stroke onset (minutes, 124 vs 397) and were more likely to receive reperfusion therapy (adjusted odds ratio, 1.57, 95% CI: 1.09, 2.27). Patients with stroke who use ambulances arrived faster and were more likely to receive reperfusion therapy compared to those using personal transport. Further public education about using ambulance services at all times, instead of personal transport when stroke is suspected is needed to optimise access to time critical care.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26018
DOI: 10.1016/j.auec.2021.01.002
Journal: Australasian Emergency Care
PubMed URL: 33642255
Type: Journal Article
Subjects: Acute Stroke
Ambulance
Emergency medicine
Health services
Patient factors
Thrombolysis
Appears in Collections:Journal articles

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