急性缺血性卒中的沉淀，EMS的使用和出现时间在卒中登记指南中。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-09-27 DOI:10.1016/j.jstrokecerebrovasdis.2025.108460

Marisa Berner MA , Mathew Reeves BVSc PhD , George S. Usmanov PhD , Kevin N. Sheth MD , Amar Dhand MD DPhil

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引用次数: 0

摘要

背景：延迟到医院就诊是提供急性脑卒中治疗的一个障碍。天气对延误的影响尚未研究。我们考察了全国范围内降水与到达时间之间的关系。方法：我们研究了2010-2019年在Get with the Guidelines®卒中医院就诊的急性缺血性卒中患者。暴露变量是从美国国家海洋和大气管理局获得的呈现当天的总日降水量，并分为无（0英寸/天）、轻度（> -1英寸/天）和重度（>1英寸/天）。主要观察指标为中风后到达医院的时间（以分钟为单位）。我们进行多元回归分析，包括分析降水量与EMS使用率的交互作用。结果：在270万例患者中，50.7%为女性，38.6%年龄≥75岁。到医院的平均时间为无降水212分钟，轻度降水219分钟，强降水223分钟。在校正分析中，与无降水相比，轻度降水与4.63分钟的延迟相关[95% CI:(2.77, 6.49)]。大降水与延迟7.69分钟相关[95% CI:(2.86, 12.52)]。EMS的使用总体上改善了到达时间，并且与轻度降水有交互作用（-6.09分钟[95% CI:(-9.79至-2.39)]）。然而，与主要降水（-2.72分钟[95% CI:(-12.38 ~ 6.93)]）没有相互作用。结论：急性脑卒中患者降水与延迟就诊有关。极端天气频率的增加要求制定紧急医疗服务战略和基础设施，以支持应对气候变化的中风护理系统。

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Precipitation, EMS use, and time to presentation of Acute Ischemic stroke in the get with the guidelines-stroke registry

Background

Delayed presentation to the hospital is a barrier for delivering acute stroke treatments. The effects of weather on delay are unstudied. We examined the relationship between precipitation and time to arrival nationwide.

Methods

We studied patients with acute ischemic stroke who presented at a Get With the Guidelines®-Stroke hospital from 2010-2019. The exposure variable was total daily precipitation on the day of presentation, obtained from the National Oceanic and Atmospheric Administration, and categorized as none (0 inches/day), mild (>0-1 inch/day), and major (>1 inch/day). The primary outcome was time to hospital arrival after stroke (in minutes). We conducted multivariate regression analysis, including analysis of interaction between precipitation level and EMS usage.

Results

In ∼2.7 million patients, 50.7% were female and 38.6% were ≥75 years old. Median time to hospital arrival was 212 minutes in no precipitation, 219 minutes in mild precipitation, and 223 minutes in major precipitation. In adjusted analyses, compared to no precipitation, mild precipitation was associated with 4.63 minutes of delay [95% CI: (2.77, 6.49)]. Major precipitation was associated with 7.69 minutes of delay [95% CI: (2.86, 12.52)]. EMS usage improved arrival time overall, and there was an interaction with mild precipitation (-6.09 minutes [95% CI: (-9.79 to -2.39)]). However, there was no interaction with major precipitation (-2.72 minutes [95% CI: (-12.38 to 6.93)]).

Conclusion

Precipitation was associated with delayed presentation to the hospital in acute stroke. Increased frequency of extreme weather calls for developing EMS strategies and infrastructure to support climate-ready stroke systems of care.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.