An emergency clinical pathway for stroke patients – results of a cluster randomised trial (isrctn41456865)
2009

Emergency Clinical Pathway for Stroke Patients

Sample size: 4895 publication Evidence: moderate

Author Information

Author(s): De Luca Assunta, Toni Danilo, Lauria Laura, Sacchetti Maria Luisa, Giorgi Rossi Paolo, Ferri Marica, Puca Emanuele, Prencipe Massimiliano, Guasticchi Gabriella

Primary Institution: Public Health Agency of the Latium Region, Rome, Italy

Hypothesis

The study aims to evaluate the effectiveness of an emergency clinical pathway (ECP) for stroke patients in the Latium emergency system.

Conclusion

The study suggests that integrating emergency medical services and emergency rooms with stroke unit networks is feasible and may improve the quality of care for stroke patients.

Supporting Evidence

  • The intervention arm had a higher proportion of eligible patients referred to the stroke unit compared to the control arm.
  • Patients in the intervention group were more likely to receive thrombolysis than those in the control group.
  • The study involved 30 entities and created 20 clusters for randomization.

Takeaway

This study shows that training emergency responders to recognize strokes can help more patients get the right care faster.

Methodology

A cluster randomized controlled trial comparing stroke patient referrals by trained emergency medical service and emergency room professionals with non-trained controls.

Potential Biases

Potential over-diagnosing by trained EMS personnel may have influenced the results.

Limitations

The study faced issues with cluster contamination and withdrawal of some participating centers, which may have affected the results.

Participant Demographics

Participants included emergency medical service and emergency room personnel, with a focus on stroke patients aged 80 or less.

Statistical Information

P-Value

p = 0.02

Confidence Interval

95% CI: 1.62–4.98

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1472-6963-9-14

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