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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 5 of 5 Research Studies DisplayedGlober N, Supples M, Persaud S
A novel emergency medical services protocol to improve treatment time for large vessel occlusion strokes.
This paper describes the outcomes of a pilot study that used novel emergency medical services (EMS) protocol to expedite transfer of patients with large vessel occlusions (LVOs) to a comprehensive stroke center (CSC). The pilot study took place from Oct. 1, 2020 to Feb. 22, 2021 with Indianapolis EMS providers. In patients with possible LVO, the providers remained at the bedside until the clinical assessment and CT angiography were complete. This 5-month mixed methods study measured case-control assessment of the protocol, number of transfers, safety during transport, and time saved in transfer compared to emergency transfers via conventional interfacility transfer agencies. The protocol was used 42 times during the study period, with four patients found to have LVOs and transferred to a CSC. Median time from decision-to-transfer to arrival at the CSC was 27.5 minutes compared to 314.5 minutes for acute non-stroke transfers during the same period.
AHRQ-funded; HS026390.
Citation: Glober N, Supples M, Persaud S .
A novel emergency medical services protocol to improve treatment time for large vessel occlusion strokes.
PLoS One 2022 Feb;17(2):e0264539. doi: 10.1371/journal.pone.0264539..
Keywords: Emergency Medical Services (EMS), Stroke, Cardiovascular Conditions, Critical Care
KS Cash, RE Adeoye, O
AHRQ Author: Zachrison
Estimated population access to acute stroke and telestroke centers in the US, 2019.
In order to provide an update on population-level access to stroke care, the investigators estimated the proportion of the US population with access to an ED with acute stroke capabilities and assessed the specific contribution of telestroke services to US population access. They observed a substantial increase in population access to acute stroke care in this cross-sectional study relative to previous reports using alternative methods, likely due to the extensive and ongoing work to improve stroke systems of care, including greater stroke center accreditation and expansion of telestroke capacity.
AHRQ-funded; HS024561.
Citation: KS Cash, RE Adeoye, O .
Estimated population access to acute stroke and telestroke centers in the US, 2019.
JAMA Netw Open 2022 Feb;5(2):e2145824. doi: 10.1001/jamanetworkopen.2021.45824..
Keywords: Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Critical Care, Access to Care
Kass-Hout T, Lee J, Tataris K
Prehospital comprehensive stroke center vs primary stroke center triage in patients with suspected large vessel occlusion stroke.
This study’s objective was to evaluate the association of a regional prehospital transport policy that directly triages patients with suspected large vascular occlusion (LVO) stroke to the nearest comprehensive stroke center with rates of endovascular therapy (EVT). This retrospective, multicenter preimplementation-postimplementation study used an interrupted time series analysis to compare treatment rates before and after implementation in patients with acute ischemic stroke (AIS) arriving at 15 primary stroke centers and 8 comprehensive stroke centers in Chicago, Illinois, via emergency medical services (EMS) transport from December 1, 2017, to May 31, 2019. Among 7709 individuals with stroke, 663 with AIS arrived within 6 hours of stroke onset by EMS transport. The EVT rate increased overall among patients with AIS postimplementation and among EMS-transported patients with AIS within 6 hours of onset. There were no differences in EVT rates in patients not arriving by EMS within the 6- to 24-hour window or by interhospital transfer or walk-in.
AHRQ-funded; HS025359.
Citation: Kass-Hout T, Lee J, Tataris K .
Prehospital comprehensive stroke center vs primary stroke center triage in patients with suspected large vessel occlusion stroke.
JAMA Neurol 2021 Oct;78(10):1220-27. doi: 10.1001/jamaneurol.2021.2485..
Keywords: Stroke, Cardiovascular Conditions, Critical Care, Emergency Medical Services (EMS)
Su CM, Warren A, Kraus C
Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage.
Int J Emerg Med 2021 Jan 19;14(1):6. doi: 10.1186/s12245-021-00329-w.
Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. In this study the investigators examined whether racial or ethnic disparities existed in acute care processes in the first hours after ICH. The investigators found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.
Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. In this study the investigators examined whether racial or ethnic disparities existed in acute care processes in the first hours after ICH. The investigators found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.
AHRQ-funded; HS024561.
Citation: Su CM, Warren A, Kraus C .
Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage.
Int J Emerg Med 2021 Jan 19;14(1):6. doi: 10.1186/s12245-021-00329-w..
Keywords: Racial and Ethnic Minorities, Disparities, Critical Care, Stroke, Cardiovascular Conditions, Outcomes
Govindarajan P, Shiboski S, Grimes B
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Investigators sought to determine whether increasing access to primary stroke centers (regionalization) led to an increase in intravenous alteplase use in acute ischemic stroke patients. Studying two urban counties in the western region of US that regionalized acute stroke care, they found that in Santa Clara County, intravenous alteplase was administered to 1.7% of patients in the pre-regionalization period and 2.1% in the post-regionalization period, while in San Mateo County, the numbers were 1.3% and 3.2%, respectively. In the post-regionalization phase, San Mateo County had greater change in paramedic stroke detection, higher number of transports to primary stroke centers, and more frequent use of intravenous alteplase at stroke centers. They concluded that greater post-regionalization improvements in San Mateo County contributed to significantly improved county-level thrombolysis use than Santa Clara County.
AHRQ-funded; HS026207; HS017965.
Citation: Govindarajan P, Shiboski S, Grimes B .
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Prehosp Emerg Care 2020 Jul-Aug;24(4):505-14. doi: 10.1080/10903127.2019.1679303..
Keywords: Stroke, Cardiovascular Conditions, Urban Health, Access to Care, Emergency Medical Services (EMS), Critical Care