title: Factors associated with use of emergency medical services in patients with acute stroke.
abstract: OBJECTIVE
  The aim of this study was to investigate the factors associated with use of emergency medical services (EMS) in patients with acute stroke.
  
  
  METHODS
  Prospective data on consecutive patients with acute stroke who presented to the emergency department of a university medical center from January 1, 2010, to July 31, 2011, were analyzed. Patients were excluded if they had an unknown residence, had onset of stroke at a nursing home or hospital, or were transferred from another hospital. Variables for all patients with stroke and ischemic stroke who did and did not use EMS were compared.
  
  
  RESULTS
  In total, 1344 patients (60% male; mean age, 68.7 years) were included. Use of EMS (n = 409; 30.4%) was significantly associated with a higher level of education (≧6 years vs <6 years; odds ratio [OR], 1.69; 95% confidence interval [CI], 1.25-2.29), a higher National Institutes of Health Stroke Scale score (OR, 1.08; 95% CI, 1.05-1.11), altered consciousness (OR, 1.88; 95% CI, 1.25-2.84), and atrial fibrillation (OR, 2.43; 95% CI, 1.71-3.44) after adjustment. For patients with ischemic stroke, use of EMS was significantly higher in cases of cardioembolism (OR, 3.04; 95% CI, 1.40-6.60) and large artery atherothrombosis (OR, 2.10; 95% CI, 1.22-3.62) than lacunar infarction.
  
  
  CONCLUSIONS
  Patients with stroke who have altered consciousness, a higher level of education, a higher National Institutes of Health Stroke Scale score, atrial fibrillation, and cardioembolic stroke were more likely to use EMS.
authors: Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors: Nai-Chuan
authors: NC
authors: Chen
authors: Ming-Ju
authors: MJ
authors: Hsieh
authors: Sung-Chun
authors: SC
authors: Tang
authors: Wen-Chu
authors: WC
authors: Chiang
authors: Kuang-Yu
authors: KY
authors: Huang
authors: Li-Kai
authors: LK
authors: Tsai
authors: Patrick Chow-In
authors: PC
authors: Ko
authors: Matthew Huei-Ming
authors: MH
authors: Ma
authors: Jiann-Shing
authors: JS
authors: Jeng
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013624:Taiwan; D014187:Transportation of Patients / Q000706:statistics & numerical data