Skip to main content

PERSPECTIVE article

Front. Stroke
Sec. Acute Stroke and Interventional Therapies
Volume 3 - 2024 | doi: 10.3389/fstro.2024.1437746

Patients with acute Intracerebral hemorrhage and severe symptoms are highly sensitive to prehospital delay. A subgroup analysis from the RESIST and TRIAGE-STROKE trials

Provisionally accepted
Anne Behrndtz Anne Behrndtz 1*Claus Z. Simonsen Claus Z. Simonsen 1Jan Valentin Jan Valentin 2Grethe Andersen Grethe Andersen 1Rolf A. Blauenfeldt Rolf A. Blauenfeldt 1
  • 1 Aarhus University, Aarhus, Denmark
  • 2 Danish Center for Clinical Health Services Research, Aalborg, Denmark

The final, formatted version of the article will be published soon.

    Background: Patients with a positive prehospital stroke severity score and underlying intracerebral hemorrhage (ICH) may be harmed by longer onset to admission times. We aimed to investigate the interaction between ICH severity and time from onset to admission on functional outcome.Methods: This is an individual patient data analysis with data from two randomized prehospital stroke trials (RESIST and TRIAGE-STROKE) using the same prehospital stroke scale. Patients were stratified according to a presence of a positive stroke severity score. They were grouped into early arrivers (admitted less than 90 minutes from onset) and late arrivers ( ≥90 minutes after onset). The primary outcome was shift towards a better functional outcome on the modified Rankin Scale (mRS).Results: A total of 212 patients had ICH. A positive stroke severity score was seen in 123 of these patients. Patients with ICH and a positive prehospital stroke severity score had a significantly worse outcome if 90 minutes or later at the hospital (aOR: 2.02, 95%CI; 1.01 to 4.12). This difference was not seen in patients without a positive severity score (adjusted odds ratio [aOR]: 0.50, 95%CI; 0.22 to 1.14). Patients with a positive score had also an increasing risk of death or severe dependency (mRS of 5-6) of 9.1%-points (95%CI:-1.6% to19.8%) per hour if they were diagnosed with ICH.Longer onset to admission time was harmful for patients with ICH and a positive prehospital stroke severity score.

    Keywords: Stroke, prehospital, intracerbral hemorrhage, Delay, Triage

    Received: 24 May 2024; Accepted: 16 Jul 2024.

    Copyright: © 2024 Behrndtz, Simonsen, Valentin, Andersen and Blauenfeldt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anne Behrndtz, Aarhus University, Aarhus, Denmark

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.