+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Relevance of prehospital stroke code activation for acute treatment measures in stroke care: a review

Relevance of prehospital stroke code activation for acute treatment measures in stroke care: a review

Cerebrovascular Diseases 34(3): 182-190

The use of emergency services with prehospital stroke assessment and early notification to the treatment hospital (stroke code) is a crucial determinant of delay time for acute stroke treatment. We reviewed and summarized the literature on prehospital stroke code system implementation. Two databases were explored (last update June 20, 2011) with 3 key words (stroke code, stroke prehospital management and stroke prehospital services). Inclusion criteria were: randomized and quasirandomized controlled trials, cohort and case-control studies, and hospital- and emergency-based registers, with no year or language restrictions. We examined the reference lists of all included articles. All potentially relevant reports and abstracts were transcribed into a specifically designed data abstraction form. Only 19 of the 680 studies which were initially retrieved, published from 1999 to 2011, fulfilled our inclusion criteria. One clinical trial was identified. Large differences in stroke code procedures and study designs within and across countries prohibited the pooling of the data. Most studies were carried out in urban areas. Assuming the rate of tissue-plasminogen activator treatment as the performance measure, most studies report a significant increase in the rate of treatment (increase between 3.2 and 16%) with only 1 study not reporting any increase. Despite its limitations, this review suggests that the use of prehospital stroke code is an important intervention to improve the accessibility of the benefits of thrombolysis, especially when implemented together with educational campaigns to optimize the awareness and behavior of patients and bystanders.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 055476672

Download citation: RISBibTeXText

PMID: 23006526

DOI: 10.1159/000341856

Related references

Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program. Cerebrovascular Diseases 27 Suppl 1: 140-147, 2009

Improved prehospital triage of patients with stroke in a specialized stroke ambulance: results of the pre-hospital acute neurological therapy and optimization of medical care in stroke study. Stroke 46(3): 740-745, 2015

Assessing the validity of the Cincinnati prehospital stroke scale and the medic prehospital assessment for code stroke in an urban emergency medical services agency. Prehospital Emergency Care 17(3): 348-353, 2014

Transcranial ultrasound from diagnosis to early stroke treatment: part 2: prehospital neurosonography in patients with acute stroke: the Regensburg stroke mobile project. Cerebrovascular Diseases 33(3): 262-271, 2012

Compliance with acute stroke care quality measures in hospitals with and without primary stroke center certification: the North Carolina Stroke Care Collaborative. Journal of the American Heart Association 3(2): E000423, 2014

Stroke health and research initiatives (SHRI): 'Following the heart' for prehospital and acute stroke care policy. Neurology India 65(4): 927-929, 2017

Influence of the stroke code activation source on the outcome of acute ischemic stroke patients. Neurology 72(19): 1709; Author Reply 1710, 2009

Influence of the stroke code activation source on the outcome of acute ischemic stroke patients. Neurology 70(15): 1238-1243, 2008

Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke. Journal of Stroke 15(2): 67-77, 2013

Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program. Journal of Stroke and Cerebrovascular Diseases 25(7): 1665-1670, 2017

A comprehensive review of prehospital and in-hospital delay times in acute stroke care. International Journal of Stroke 4(3): 187-199, 2009

Higher prehospital priority level of stroke improves thrombolysis frequency and time to stroke unit: the Hyper Acute STroke Alarm (HASTA) study. Stroke 43(10): 2666-2670, 2013

Influence of the experience and of out-of-hospital stroke code in thrombolytic treatment of acute stroke. Neurologia 23(6): 349-355, 2008

"Stroke code". Shortening the delay in reperfusion treatment of acute ischemic stroke. Medicina Clinica 113(13): 481-483, 1999

Inflammation in acute ischemic stroke and its relevance to stroke critical care. Neurocritical Care 9(1): 125-138, 2007