Table 2 A comparison of the hospital course, management and outcomes of suspected stroke patients using emergency medical services vs. non-emergency medical services users
From: Emergency medical services utilization in acute stroke in Qatar - an observational cohort study
Variables | Category | Use of Emergency Medical Services (EMS), n (%) | Total | Odds Ratio | 95% CI | p-value | |
|---|---|---|---|---|---|---|---|
|  |  | Yes, n = 7734 (%) | No, n = 4158 (%) | N = 11,892 (%) |  |  |  |
NIHSSa at admission, n I (%) | 0 (No symptom) | 2069 (27.3) | 1536 (37.4) | 3605 (30.8) | 0.63 | 0 0.58–0.68 | < 0.001 |
|  | 1–4 | 2846 (37.5) | 1847 (44.9) | 4693 (40.1) | 0.73 | 0.68–0.79 | < 0.001 |
|  | 5–15 | 1904 (25.1) | 586 (14.3) | 2490 (21.3) | 2.01 | 1.82–2.23 | < 0.001 |
|  | 16–20 | 374 (4.9) | 67 (1.6) | 441 (3.8) | 3.13 | 2.41–4.06 | < 0.001 |
|  | 20 and over> | 397 (5.2) | 74 (1.8) | 471 (4.0) | 3.01 | 2.34–3.86 | < 0.001 |
Door to needle time (Median, IQR), mins |  | 49 (31–69) | 62 (47–99) | 52 (34–73) |  |  | < 0.001 |
Thrombolysis (tPA given) n, % of IS | Total | 645 (16.8) | 138 (6.9) | 783 (13.4) | 2.65 | 2.18–3.21 | < 0.001 |
|  | Ischemic stroke | 603 (15.8) | 122 (6.1) | 725 (12.4) | 2.87 | 2.33–3.54 | < 0.001 |
|  | TIA | 4 (0.1) | 5 (0.2) | 9 (0.1) | 0.65 | 0.12–3.04 | 0.52 |
|  | Mimic | 37 (0.9) | 11 (0.5) | 48 (0.8) | 2.19 | 1.08–4.77 | < 0.05 |
| Â | CVST | 1 (0.02) | 0 (0) | 1 (0.02) | Â | Â | 0.45 |
Thrombectomy, n (% of IS) |  | 230 (6.0) | 37 (1.9) | 267 (4.6) | 3.4 | 2.4–4.8 | < 0.001 |
Disposition, n (%) | Home | 5139 (66.5) | 3367 (80.9) | 8506 (71.5) | 0.46 | 0.42–0.51 | < 0.001 |
|  | Rehab | 1324 (17.1) | 320 (7.7) | 1644 (13.8) | 2.47 | 2.17–2.81 | < 0.001 |
|  | Long term care | 285 (3.7) | 68 (1.6) | 353 (2.9) | 2.30 | 1.76-3.00 | < 0.001 |
|  | Died in Hospital | 219 (2.8) | 66 (1.6) | 285 (2.4) | 1.80 | 1.36–2.38 | < 0.001 |
|  | Other specialty | 767 (9.9) | 337 (8.1) | 1104 (9.3) | 1.24 | 1.09–1.42 | < 0.01 |
Length of stay (mean ± SD) in days | Total population | 5.7 ± 8.7 | 4.3 ± 9.4 | 5.2 ± 9.0 |  |  | < 0.001 |
|  | Ischemic stroke | 6.4 ± 9.5 | 5.05 ± 5.9 | 5.9 ± 8.5 |  |  | < 0.001 |
|  | TIA | 2.08 ± 2.1 | 2.6 ± 8.7 | 2.3 ± 6.1 |  |  | 0.42 |
|  | ICH | 11.7 ± 11.3 | 11.2 ± 17.0 | 11.6 ± 12.4 |  |  | < 0.01 |
|  | Mimic | 2.4 ± 3.1 | 2.6 ± 11.4 | 2.5 ± 7.5 |  |  | < 0.001 |
|  | CVST | 8.5 ± 8.4 | 5.9 ± 4.9 | 7.6 ± 7.4 |  |  | 0.08 |
Discharge mRSb 0–2, n (%) | Total | 4774 (61.9) | 3290 (79.4) | 8064 (67.9) | 0.43 | 0.39–0.46 | < 0.001 |
|  | Ischemic stroke | 2080 (54.5) | 1409 (71.1) | 3489 (60.2) | 0.72 | 0.66–0.78 | < 0.001 |
|  | TIA | 622 (92.2) | 529 (96.2) | 1151 (93.9) | 0.59 | 0.53–0.68 | < 0.001 |
|  | ICH | 303 (28.3) | 111 (48.5) | 414 (31.8) | 1.48 | 1.19–1.85 | < 0.001 |
|  | Mimic | 1687 (81.9) | 1195 (89.9) | 2882 (85.1) | 0.69 | 0.63–0.75 | < 0.001 |
|  | CVST | 82 (82.8) | 46 (85.2) | 128 (83.6) | 0.96 | 0.67–1.37 | 0.82 |
mRSb 0–2 at 90 days follow up, n (%) (n = 7005) | Total | 3032 (66.6) | 2064 (84.0) | 5096 (72.7) | 0.65 | 0.61–0.71 | < 0.001 |
|  | Ischemic stroke | 1753 (63.9) | 1160 (80.0) | 2913 (41.6) | 0.75 | 0.69–0.83 | < 0.001 |
|  | TIA | 533 (93.2) | 482 (96.7) | 1015 (14.5) | 0.56 | 0.49–0.64 | < 0.001 |
|  | ICH | 304 (39.8) | 97 (56.4) | 401 (5.7) | 1.71 | 1.36–2.16 | < 0.001 |
|  | Mimic | 377 (94.5) | 283 (96.6) | 660 (9.4) | 0.70 | 0.56–0.82 | < 0.001 |
|  | CVST | 65 (90.3) | 42 (95.4) | 107 (1.5) | 0.83 | 0.56–1.22 | 0.35 |
Dead at discharge (n, % of deaths for each category) | Total | 211 (2.7) | 66 (1.6) | 277 (2.3) | 1.74 | 1.32–2.29 | < 0.001 |
|  | Ischemic stroke | 80 (2.1) | 35 (1.7) | 115 (0.9) | 1.19 | 0.80–1.77 | 0.38 |
| Â | TIA | 0 | 0 | 0 | Â | Â | Â |
|  | ICH | 115 (10.7) | 27 (11.8) | 142 (1.2) | 0.89 | 0.57–1.39 | 0.63 |
|  | Mimic | 16 (0.8) | 3 (0.2) | 19 (0.2) | 3.45 | 1.07–11.1 | < 0.05 |
| Â | CVST | 0 | 1 (1.8) | 1 (0.01) | Â | Â | Â |
Complications, n (%) | Pneumonia | 375 (4.8) | 79 (1.9) | 454 (3.8) | 2.63 | 2.05–3.40 | < 0.001 |
|  | UTI | 277 (3.6) | 52 (1.3) | 329 (2.7) | 2.93 | 2.16–4.03 | < 0.001 |
|  | DVT/PE | 6 (0.1) | 7 (0.2) | 13 (0.1) | 0.46 | 0.12–1.60 | 0.15 |
|  | Bedsores | 47 (0.6) | 18 (0.4) | 65 (0.5) | 1.40 | 0.80–2.57 | 0.21 |
|  | Sepsis | 268 (3.5) | 84 (2) | 352 (2.9) | 1.74 | 1.35–2.25 | < 0.001 |