Abstract:
:Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) can improve clinical outcome in eligible patients with acute ischemic stroke (AIS). However, its efficacy is strongly time-dependent. This study was aimed to examine whether prehospital notification by emergency medical service (EMS) providers could reduce onset to needle time (ONT) and improve neurological outcome in AIS patients who received IVT. We prospectively collected the consecutive clinical and time data of AIS patients who received IVT during one year after the initiation of prehospital notification procedure (PNP). Patients were divided into three groups, including patients that transferred by EMS with and without PNP and other means of transportation (non-EMS). We then compared the effect of EMS with PNP and EMS use only on ONT, and the subsequent neurological outcome. Good outcome was defined as modified Rankin Scale score of 0-2 at 3-months. In 182 patients included in this study, 77 (42.3%) patients were transferred by EMS, of whom 41 (53.2%) patients entered PNP. Compared with non-EMS group, EMS without PNP group greatly shortened the onset to door time (ODT), but EMS with PNP group showed both a significantly shorter DNT (41.3 ± 10.7 min vs 51.9±23.8 min, t=2.583, p=0.012) and ODT (133.2 ± 90.2 min vs 174.8 ± 105.1 min, t=2.228, p=0.027) than non-EMS group. Multivariate analysis showed that the use of EMS with PNP (OR=2.613, p=0.036), but not EMS (OR=1.865, p=0.103), was independently associated with good outcome after adjusting for age and baseline NIHSS score. When adding ONT into the regression model, ONT (OR=0.994, p=0.001), but not EMS with PNP (OR=1.785, p=0.236), was independently associated with good outcome. EMS with PNP, rather than EMS only, improved stroke outcome by shortening ONT. PNP could be a feasible strategy for better stroke care in Chinese urban area.
journal_name
Aging Disjournal_title
Aging and diseaseauthors
Zhang S,Zhang J,Zhang M,Zhong G,Chen Z,Lin L,Lou Mdoi
10.14336/AD.2017.0601subject
Has Abstractpub_date
2018-06-01 00:00:00pages
426-434issue
3issn
2152-5250pii
ad-9-3-426journal_volume
9pub_type
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journal_title:Aging and disease
pub_type: 杂志文章
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journal_title:Aging and disease
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journal_title:Aging and disease
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journal_title:Aging and disease
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journal_title:Aging and disease
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更新日期:2011-04-01 00:00:00
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journal_title:Aging and disease
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journal_title:Aging and disease
pub_type: 杂志文章
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journal_title:Aging and disease
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doi:
更新日期:2013-03-07 00:00:00
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journal_title:Aging and disease
pub_type: 杂志文章,评审
doi:10.14336/AD.2015.0330
更新日期:2015-10-01 00:00:00
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journal_title:Aging and disease
pub_type: 杂志文章,评审
doi:10.14336/AD.2019.0621
更新日期:2020-05-09 00:00:00
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journal_title:Aging and disease
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journal_title:Aging and disease
pub_type: 杂志文章,评审
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journal_title:Aging and disease
pub_type: 杂志文章
doi:
更新日期:2012-08-01 00:00:00
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journal_title:Aging and disease
pub_type: 杂志文章,评审
doi:10.14336/AD.2017.0829
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journal_title:Aging and disease
pub_type: 杂志文章,评审
doi:10.14336/AD.2016.1022
更新日期:2017-05-02 00:00:00
abstract::The TOR (target of rapamycin) pathway has been convincingly shown to promote aging in various model organisms. In mice, inhibiting mTOR (mammalian TOR) by rapamycin treatment later in life can significantly extend lifespan and mitigate multiple age-related diseases. However, the underlying mechanisms are poorly unders...
journal_title:Aging and disease
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journal_title:Aging and disease
pub_type: 杂志文章,评审
doi:10.14336/AD.2019.1021
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journal_title:Aging and disease
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journal_title:Aging and disease
pub_type: 杂志文章
doi:10.14336/AD.2015.0505
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journal_title:Aging and disease
pub_type: 杂志文章
doi:10.14336/AD.2019.0315
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journal_title:Aging and disease
pub_type: 杂志文章
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journal_title:Aging and disease
pub_type: 杂志文章
doi:10.14336/AD.2015.0906
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journal_title:Aging and disease
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journal_title:Aging and disease
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
abstract::Aging, type 2 diabetes, and male gender are major risk factors leading to increased COVID-19 morbidity and mortality. Thymic production and the export of naïve T cells decrease with aging through the effects of androgens in males and in type 2 diabetes. Furthermore, with aging, recovery of naïve T-cell populations aft...
journal_title:Aging and disease
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