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Stroke Symptoms Present in Ambulance Records and Prehospital Time Delay-A Retrospective Cohort Study.

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Τίτλος: Stroke Symptoms Present in Ambulance Records and Prehospital Time Delay-A Retrospective Cohort Study.
Συγγραφείς: Bakke I; Section for Quality and Patient Safety, Nordland Hospital Trust, Bodø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway. Electronic address: ida.bakke@uit.no., Lund CG; Department of Neurology, Oslo University Hospital, Oslo, Norway., Salvesen R; Department of Neurology, Nordland Hospital Trust, Bodø, Norway., Benum E; Department of Medicine, Helgeland Hospital Trust, Sandnessjøen, Norway., Normann B; Faculty of Nursing and Health Science, Nord University, Bodø, Norway; Department of Physiotherapy, Nordland Hospital Trust, Bodø, Norway., Trichet LO; Department of Research, Nordland Hospital Trust, Bodø, Norway., Carlsson M; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, Nordland Hospital Trust, Bodø, Norway.
Πηγή: The Journal of emergency medicine [J Emerg Med] 2026 Oct; Vol. 89, pp. 156-164. Date of Electronic Publication: 2026 Aug 23.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 8412174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0736-4679 (Print) Linking ISSN: 07364679 NLM ISO Abbreviation: J Emerg Med Subsets: MEDLINE
Imprint Name(s): Publication: <2010>- : New York : Elsevier
Original Publication: New York : Pergamon Press, c1983-
Ιατρικοί όροι (MeSH): Stroke*/diagnosis , Ambulances*/statistics & numerical data , Time-to-Treatment*/statistics & numerical data , Time-to-Treatment*/standards, Emergency Medical Services/statistics & numerical data ; Humans ; Retrospective Studies ; Male ; Female ; Norway ; Aged ; Aged, 80 and over ; Middle Aged ; Time Factors ; Cohort Studies ; Treatment Delay ; Logistic Models ; Triage
Περίληψη: Background: The outcome of a stroke is highly dependent on time to treatment. Reducing prehospital delay is crucial to increase access to effective stroke treatment.
Objective: We aimed to examine how stroke symptoms are recorded and to assess the association between prehospital registration of stroke symptoms and stroke triage and prehospital delay.
Methods: We included patients with a final diagnosis of acute stroke, admitted to Nordland Hospital Trust and Helgeland Hospital Trust in Norway from June 2018 to May 2019. Data were extracted from the Emergency Medical Communication Center records, from ambulance reports, and hospital admissions records. Associations between Facial Arm Speech Test (FAST) symptoms and prehospital time were analyzed using linear regression models and the Mann-Whitney U test. Logistic regression was used to assess the association between FAST symptoms and stroke alert.
Results: Of 295 patients, 273 (92.5%) had ≥1 stroke symptom recorded, and 224 (75.9%) had one or more FAST symptoms. Documentation of FAST symptoms in ambulance records was associated with a higher likelihood of activating a stroke alert; odds ratio 6.7 (95% confidence interval: 3.5-13.1) and a significantly shorter prehospital time (17.0 vs. 34.5 min, p = 0.024).
Conclusion: Recording of FAST symptoms in the ambulance was associated with the use of stroke alerts and shorter prehospital time delay. However, 24.1% of the patients with a confirmed stroke did not present with FAST symptoms, highlighting the need to improve prehospital stroke recognition and triage.
(Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. Maria Carlsson, PhD, MD, has received an honorary award from AstraZeneca for a lecture.
Contributed Indexing: Keywords: FAST symptom; emergency medical services; prehospital care; prehospital delay; stroke
Entry Date(s): Date Created: 20260918 Date Completed: 20260926 Latest Revision: 20260926
Update Code: 20260927
DOI: 10.1016/j.jemermed.2026.08.008
PMID: 42759268
Βάση Δεδομένων: MEDLINE
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  Data: Stroke Symptoms Present in Ambulance Records and Prehospital Time Delay-A Retrospective Cohort Study.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Bakke+I%22&quot;&gt;Bakke I&lt;/searchLink&gt;; Section for Quality and Patient Safety, Nordland Hospital Trust, Bod&#248;, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Troms&#248;, Norway. Electronic address: ida.bakke@uit.no.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lund+CG%22&quot;&gt;Lund CG&lt;/searchLink&gt;; Department of Neurology, Oslo University Hospital, Oslo, Norway.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Salvesen+R%22&quot;&gt;Salvesen R&lt;/searchLink&gt;; Department of Neurology, Nordland Hospital Trust, Bod&#248;, Norway.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Benum+E%22&quot;&gt;Benum E&lt;/searchLink&gt;; Department of Medicine, Helgeland Hospital Trust, Sandnessj&#248;en, Norway.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Normann+B%22&quot;&gt;Normann B&lt;/searchLink&gt;; Faculty of Nursing and Health Science, Nord University, Bod&#248;, Norway; Department of Physiotherapy, Nordland Hospital Trust, Bod&#248;, Norway.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Trichet+LO%22&quot;&gt;Trichet LO&lt;/searchLink&gt;; Department of Research, Nordland Hospital Trust, Bod&#248;, Norway.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Carlsson+M%22&quot;&gt;Carlsson M&lt;/searchLink&gt;; Department of Clinical Medicine, UiT The Arctic University of Norway, Troms&#248;, Norway; Department of Neurology, Nordland Hospital Trust, Bod&#248;, Norway.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: The outcome of a stroke is highly dependent on time to treatment. Reducing prehospital delay is crucial to increase access to effective stroke treatment.&lt;br /&gt;Objective: We aimed to examine how stroke symptoms are recorded and to assess the association between prehospital registration of stroke symptoms and stroke triage and prehospital delay.&lt;br /&gt;Methods: We included patients with a final diagnosis of acute stroke, admitted to Nordland Hospital Trust and Helgeland Hospital Trust in Norway from June 2018 to May 2019. Data were extracted from the Emergency Medical Communication Center records, from ambulance reports, and hospital admissions records. Associations between Facial Arm Speech Test (FAST) symptoms and prehospital time were analyzed using linear regression models and the Mann-Whitney U test. Logistic regression was used to assess the association between FAST symptoms and stroke alert.&lt;br /&gt;Results: Of 295 patients, 273 (92.5%) had ≥1 stroke symptom recorded, and 224 (75.9%) had one or more FAST symptoms. Documentation of FAST symptoms in ambulance records was associated with a higher likelihood of activating a stroke alert; odds ratio 6.7 (95% confidence interval: 3.5-13.1) and a significantly shorter prehospital time (17.0 vs. 34.5 min, p = 0.024).&lt;br /&gt;Conclusion: Recording of FAST symptoms in the ambulance was associated with the use of stroke alerts and shorter prehospital time delay. However, 24.1% of the patients with a confirmed stroke did not present with FAST symptoms, highlighting the need to improve prehospital stroke recognition and triage.&lt;br /&gt; (Copyright &#169; 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
– Name: Abstract
  Label: Competing Interests
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  Data: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. Maria Carlsson, PhD, MD, has received an honorary award from AstraZeneca for a lecture.
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        Value: 10.1016/j.jemermed.2026.08.008
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        Text: English
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        StartPage: 156
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      – SubjectFull: Emergency Medical Services statistics & numerical data
        Type: general
      – SubjectFull: Humans
        Type: general
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              Text: 2026 Oct
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