Kamol UdolYongchai NilanontDusit SujiraratJirathida Poaremath2024-02-072024-02-07201420142014Thesis (M.Sc. (Epidemiology))--Mahidol University, 2014https://repository.li.mahidol.ac.th/handle/123456789/95231Epidemiology (Mahidol University 2014)This prospective cohort study aimed to determine the effect of emergency medical services (EMS) utilization on pretreatment time, rate of thrombolytic therapy and 3-month clinical outcomes in acute ischemic stroke patients. Two hundred and eighty patients who had their first acute ischemic stroke within 24 hours were enrolled from 3 tertiary-care hospitals in Bangkok. Utilization of EMS, demographic and clinical data were obtained from interviews with patients and/or caregivers, and a review of medical records. Clinical outcome at 3 months was obtained from telephone interviews with patients and/or caregivers and was classified as favorable if the modified Rankin Scale (mRS) result was 0 - 2, and unfavorable otherwise. Multiple logistic regression analysis was used to determine the association between EMS utilization and clinical outcome. At 3 months, 43.6% of patients utilizing EMS had a favorable clinical outcome as compared to 53.0% in patients not using EMS [adjusted odds ratio (OR) 0.76, 95% confidence interval (CI) 0.33 to 1.79, p = 0.53]. The effect of EMS utilization on clinical outcomes differed significantly between patients with and without a history of hypertension (with hypertension, adjusted OR 0.14, 95% CI 0.03 to 0.82, p = 0.029; without hypertension, adjusted OR 4.56, 95% CI 0.92 to 22.55, p = 0.063; p for interaction = 0.038). Utilization of EMS, as compared to not using EMS, significantly decreased transportation time (42 versus 60 minutes, p = 0.001), waiting time (5 versus 10 minutes, p < 0.001) and significantly increased the rate of r-tPA therapy (30.0% versus 10.4%, p = 0.001).ix, 76 leaves : ill.application/pdfengผลงานนี้เป็นลิขสิทธิ์ของมหาวิทยาลัยมหิดล ขอสงวนไว้สำหรับเพื่อการศึกษาเท่านั้น ต้องอ้างอิงแหล่งที่มา ห้ามดัดแปลงเนื้อหา และห้ามนำไปใช้เพื่อการค้าEmergency medical services -- ThailandEmergency management -- ThailandTransient ischemic attackMaster ThesisMahidol University