Hacettepe Üniversitesi Tıp Fakültesi Erişkin Acil Servise İnme Günlerinde 112 Ambulans Ekiplerince İnme Ön Tanısıyla Yönlendirilen Hastaların Retrospektif Analizi

Abstract

Akhan, O; Retrospective Analysis of Patients Referred to Emergency Department Of Hacettepe University Faculty with a Preliminary Diagnosis of Stroke by 112 Ambulance Teams on the Days Stroke, Hacettepe University Faculty of Medicine, Emergency Medicine Thesis. Ankara, 2024. Acute stroke is one of the critical diseases in terms of morbidity and mortality. Timely treatment of acute stroke depends on early diagnosis and triage. It is evident that improved methods are required fort he recognition of stroke in the pre-hospital setting. Diseases presenting with stroke-like symptoms may result in overcrowding in stroke centres, particularly in investigations and imaging, and may consequently delay the treatment of stroke patients. The objective of this study was to evaluate whether the development of scoring systems to enhance the recognisability of stroke in the field would lead to an increase in the diagnostic accuracy of acute stroke. In this study, the processes of pre-hospital scoring, diagnosis, treatment, and outcomes in the emergency department of patients referred to Hacettepe University Adult Emergency Department with a preliminary diagnosis of acute stroke by 112 teams on stroke days determined by the Ministry of Health Ankara Provincial Health Directorate between 01/01/2022 and 31/12/2022 were evaluated. A total of 410 patients who had been referred with a preliminary diagnosis of stroke were included in the study. Cincinati and Los Angeles (LA) prehospital stroke scoring systems were used in our study. While the sensitivity of the Cincinati score in these patients in detecting stroke was 96.41%, its specificity was found to be 13.9%. The Los Angeles (LA) score was found to be positive in 84.3% of patients with stroke and negative in 15.7%, while LA was positive in 48.1% and negative in 51.9% of patients without stroke. While the Cincinnati and LA prehospital stroke scoring systems can detect stroke with a high sensitivity, they cannot exclude stroke as a diagnosis, which leads to the referral of stroke mimicking patient groups to stroke units. This leads to overcrowding in stroke centres and patients are unable to receive optimal treatment. We think that the intensity may be reduced by developing pre-hospital scoring systems.