AI Article Synopsis
- This study evaluated a prehospital bypass strategy for large vessel occlusion strokes using the G-FAST test to improve patient outcomes in a metropolitan area.
- It compared two groups of stroke patients: one before the intervention (802 patients) and one during the intervention using G-FAST (695 patients), focusing on rates of endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT).
- Results indicated that the intervention group had significantly higher rates of EVT and IVT, although they experienced longer prehospital and hospital times overall, suggesting that the bypass strategy is beneficial for stroke patients.
Article Abstract
Background/purpose: A prehospital bypass strategy was suggested for large vessel occlusion. This study aimed to evaluate the effect of a bypass strategy using the gaze-face-arm-speech-time test (G-FAST) implemented in a metropolitan community.
Methods: Pre-notified patients with positive Cincinnati Prehospital Stroke Scale and symptom onset <3 h from July 2016 to December 2017 (pre-intervention period) and those with positive G-FAST and symptom onset <6 h from July 2019 to December 2020 (intervention period) were included. Patients aged <20 years and those with missing in-hospital data were excluded. The primary outcomes were the rates of receiving endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT). The secondary outcomes were total prehospital time, door-to-computed tomography (CT) time, door-to-needle (DTN) time, and door-to-puncture (DTP) time.
Results: We included 802 and 695 pre-notified patients from the pre-intervention and intervention periods, respectively. The characteristics of the patients in the two periods were similar. In the primary outcomes, pre-notified patients during the intervention period showed higher rates of receiving EVT (4.49% vs. 15.25%, p < 0.001) and IVT (15.34% vs. 21.58%, p = 0.002). In the secondary outcomes, pre-notified patients during intervention period had longer total prehospital time (mean 23.38 vs 25.23 min, p < 0.001), longer door-to-CT time (median 10 vs 11 min, p < 0.001), longer DTN time (median 53 vs 54.5 min, p < 0.001) but shorter DTP time (median 141 vs 139.5 min, p < 0.001).
Conclusion: The prehospital bypass strategy with G-FAST showed benefits for stroke patients.
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| http://dx.doi.org/10.1016/j.jfma.2023.04.005 | DOI Listing |
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