A potential method of identifying stroke and other intracranial lesions in a prehospital setting

Show full item record



Permalink

http://hdl.handle.net/10138/316229

Citation

Saviluoto , A , Harve-Rytsälä , H , Lääperi , M , Kirves , H , Jantti , H & Nurmi , J 2020 , ' A potential method of identifying stroke and other intracranial lesions in a prehospital setting ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 28 , no. 1 , 39 . https://doi.org/10.1186/s13049-020-00728-7

Title: A potential method of identifying stroke and other intracranial lesions in a prehospital setting
Author: Saviluoto, Anssi; Harve-Rytsälä, Heini; Lääperi, Mitja; Kirves, Hetti; Jantti, Helena; Nurmi, Jouni
Other contributor: University of Helsinki, HUS Emergency Medicine and Services
University of Helsinki, Hyvinkää Hospital Area
University of Helsinki, HUS Emergency Medicine and Services




Date: 2020-05-13
Language: eng
Number of pages: 7
Belongs to series: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-020-00728-7
URI: http://hdl.handle.net/10138/316229
Abstract: Background Identifying stroke and other intracranial lesions in patients with a decreased level of consciousness may be challenging in prehospital settings. Our objective was to investigate whether the combination of systolic blood pressure, heart rate and age could be used to identify intracranial lesions. Methods We conducted a retrospective case-control study including patients with a decreased level of consciousness who had their airway secured during prehospital care. Patients with intracranial lesions were identified based on the final diagnoses at the end of hospitalization. We investigated the ability of systolic blood pressure, heart rate and age to identify intracranial lesions and derived a decision instrument. Results Of 425 patients, 127 had an intracranial lesion. Patients with a lesion were characterized by higher systolic blood pressure, lower heart rate and higher age (P <0.0001 for all). A systolic blood pressure >= 140 mmHg had an odds ratio (OR) of 3.5 (95% confidence interval [CI] 1.7 to 7.0), and > 170 mmHg had an OR of 8.2 (95% CI 4.5-15.32) for an intracranial lesion (reference: <140 mmHg). A heart rate <100 beats/min had an OR of 3.4 (95% CI 2.0 to 6.0, reference: >= 100). Age 50-70 had an OR of 4.1 (95% CI 2.0 to 9.0), and > 70 years had an OR of 10.2 (95% CI 4.8 to 23.2), reference: <50. Logarithms of ORs were rounded to the nearest integer to create a score with 0-2 points for age and blood pressure and 0-1 for heart rate, with an increasing risk for an intracranial lesion with higher scores. The area under the receiver operating characteristics curve for the instrument was 0.810 (95% CI 0.850-0.890). Conclusions An instrument combining systolic blood pressure, heart rate and age may help identify stroke and other intracranial lesions in patients with a decreased level of consciousness in prehospital settings.
Subject: Blood pressure
Heart rate
Age
Stroke
Emergency medical services
Intracranial pressure
Intubation
intratracheal
BLOOD-PRESSURE
BRAIN
CONSCIOUSNESS
3126 Surgery, anesthesiology, intensive care, radiology
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
document.pdf 701.0Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record