Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation

Objectives: We aimed to determine whether there are sex differences in prehospital accuracy of the Stockholm Stroke Triage System (SSTS) to predict large artery occlusion (LAO) stroke, and endovascular thrombectomy (EVT), and whether clinical characteristics differ between men and women undergoing “...

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Autores principales:	Elin Wiebert, Annika Berglund, Christina Sjöstrand, Einar E. Eriksson, Michael V. Mazya
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	acute ischemic stroke thrombectomy triage telemedicine sex characteristics Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/5a069015ec0b4a5ebf05fd35576a3098
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spelling	oai:doaj.org-article:5a069015ec0b4a5ebf05fd35576a30982021-12-01T13:19:27ZSex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation1664-229510.3389/fneur.2021.765296https://doaj.org/article/5a069015ec0b4a5ebf05fd35576a30982021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.765296/fullhttps://doaj.org/toc/1664-2295Objectives: We aimed to determine whether there are sex differences in prehospital accuracy of the Stockholm Stroke Triage System (SSTS) to predict large artery occlusion (LAO) stroke, and endovascular thrombectomy (EVT), and whether clinical characteristics differ between men and women undergoing “code stroke” ambulance transport.Materials and Methods: This prospective observational study collected data between October 2017 and October 2018. We included 2,905 patients, transported as “code stroke,” by nurse-staffed ground ambulance, to a Stockholm Region hospital. Exclusion criteria were private or helicopter transport, onset outside Stockholm, and in-hospital stroke. We compared overall accuracy, sensitivity, specificity, positive and negative predictive values, and clinical characteristics between sexes.Results: No significant sex differences in SSTS predictive performance for LAO or EVT were found, overall accuracy for LAO 87.3% in women vs. 86.7% in men. Women were median 4 years older and more frequently had stroke mimics (46.2 vs. 41.8%). Women more commonly had decreased level of consciousness (14.0 vs. 10.2%) and moderate-to-severe motor symptoms (by 2.7–3.8 percentage points), and less commonly limb ataxia (7.2 vs. 9.7%).Conclusions: The SSTS had equal predictive performance for LAO and EVT among men and women, despite minor sex differences in the clinical characteristics in patients undergoing ambulance transport for suspected stroke.Elin WiebertAnnika BerglundAnnika BerglundChristina SjöstrandChristina SjöstrandEinar E. ErikssonEinar E. ErikssonMichael V. MazyaMichael V. MazyaFrontiers Media S.A.articleacute ischemic strokethrombectomytriagetelemedicinesex characteristicsNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute ischemic stroke thrombectomy triage telemedicine sex characteristics Neurology. Diseases of the nervous system RC346-429
spellingShingle	acute ischemic stroke thrombectomy triage telemedicine sex characteristics Neurology. Diseases of the nervous system RC346-429 Elin Wiebert Annika Berglund Annika Berglund Christina Sjöstrand Christina Sjöstrand Einar E. Eriksson Einar E. Eriksson Michael V. Mazya Michael V. Mazya Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation
description	Objectives: We aimed to determine whether there are sex differences in prehospital accuracy of the Stockholm Stroke Triage System (SSTS) to predict large artery occlusion (LAO) stroke, and endovascular thrombectomy (EVT), and whether clinical characteristics differ between men and women undergoing “code stroke” ambulance transport.Materials and Methods: This prospective observational study collected data between October 2017 and October 2018. We included 2,905 patients, transported as “code stroke,” by nurse-staffed ground ambulance, to a Stockholm Region hospital. Exclusion criteria were private or helicopter transport, onset outside Stockholm, and in-hospital stroke. We compared overall accuracy, sensitivity, specificity, positive and negative predictive values, and clinical characteristics between sexes.Results: No significant sex differences in SSTS predictive performance for LAO or EVT were found, overall accuracy for LAO 87.3% in women vs. 86.7% in men. Women were median 4 years older and more frequently had stroke mimics (46.2 vs. 41.8%). Women more commonly had decreased level of consciousness (14.0 vs. 10.2%) and moderate-to-severe motor symptoms (by 2.7–3.8 percentage points), and less commonly limb ataxia (7.2 vs. 9.7%).Conclusions: The SSTS had equal predictive performance for LAO and EVT among men and women, despite minor sex differences in the clinical characteristics in patients undergoing ambulance transport for suspected stroke.
format	article
author	Elin Wiebert Annika Berglund Annika Berglund Christina Sjöstrand Christina Sjöstrand Einar E. Eriksson Einar E. Eriksson Michael V. Mazya Michael V. Mazya
author_facet	Elin Wiebert Annika Berglund Annika Berglund Christina Sjöstrand Christina Sjöstrand Einar E. Eriksson Einar E. Eriksson Michael V. Mazya Michael V. Mazya
author_sort	Elin Wiebert
title	Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation
title_short	Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation
title_full	Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation
title_fullStr	Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation
title_full_unstemmed	Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation
title_sort	sex equitable prehospital stroke triage using symptom severity and teleconsultation
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/5a069015ec0b4a5ebf05fd35576a3098
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Sex Equitable Prehospital Stroke Triage Using Symptom Severity and Teleconsultation

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