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Ann Geriatr Med Res > Volume 21(4); 2017 > Article
Annals of Geriatric Medicine and Research 2017;21(4):164-167.
DOI: https://doi.org/10.4235/agmr.2017.21.4.164    Published online December 31, 2017.
Clinical Characteristics of Elderly Acute Ischemic Stroke Patients Calling Emergency Medical Services
In Hwan Lim, Hyung Jong Park, Hyun Young Park, Kyeong Ho Yun, Dae Han Wi, Young Hoon Lee
<sup>1</sup>Department of Neurology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science and Regional Cardiocerebrovascular Center, Iksan, <sup>2</sup>Department of Neurology, Yonsei University College of Medicine, Seoul, <sup>3</sup>Department of Cardiovascular Medicine, Wonkwang University School of Medicine, Iksan, <sup>4</sup>Department of Emergency Medicine, Wonkwang University Sanbon Medical Center, Gunpo, <sup>5</sup>Department of Preventive Medicine, Wonkwang University School of Medicine and Regional Cardiocerebrovascular Center, Iksan, Korea
Correspondence:  Hyun Young Park, Tel: +82-63-859-1410, Fax: +82-63-842-7379, 
Email: hypppark@hanmail.net
Abstract
BACKGROUND
Time is the most important determining factor in acute ischemic stroke (AIS) treatment. Calling emergency medical services (EMS) during an AIS can reduce the time until treatment. Although differences in clinical characteristics, including sex, have been studied in patients with acute coronary syndrome, limited data are available on the differences among patients with AIS who call EMS, especially elderly patients.
METHODS
Patients aged 65 years or older who had received a diagnosis of AIS within 1 week of hospitalization were recruited and analyzed within 24 hours after symptom onset between January 1, 2012 and December 31, 2015. Calls to EMS was assessed by self-report during an in-hospital interview and verified using structured chart reviews to determine clinical differences among patients calls to EMS.
RESULTS
Of the 1,002 patients studied, 414 patients (41.3%) called EMS. A similar percentage of women and men with AIS called EMS (43.1% and 39.3%, respectively). The group calls to EMS had a faster median arrival time at the hospital (159 minutes vs. 793 minutes) and higher National Institutes of Health Stroke Scale (NIHSS) score (8.2±6.25 vs. 4.28±3.73). After adjusting for sociodemographic factors, EMS users were found to have shorter median onset-to-door time and higher NIHSSscores (odds ratio [OR], 3.538; 95% confidence interval [CI], 2.333–5.366; p < 0.01, and OR, 3.336; 95% CI, 1.032–10.786; p < 0.05, respectively).
CONCLUSION
Our study suggests that calls to EMS reduces prehospital delay and expedites treatment for stroke. We expect that a wide-ranging and specialized educational program for increasing EMS use and enhancing stroke knowledge will lead to early hospital arrival for all age groups.
Key Words: Emergency medical services, Stroke, Education, Prognosis


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