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Population-based intervention to reduce prehospital delays in patients with cerebrovascular events.

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Population-based intervention to reduce prehospital delays in patients with cerebrovascular events. / Müller-Nordhorn, Jacqueline; Wegscheider, Karl; Nolte, Christian H; Jungehülsing, Gerhard J; Rossnagel, Karin; Reich, Andreas; Roll, Stephanie; Villringer, Arno; Willich, Stefan N.

In: JAMA INTERN MED, Vol. 169, No. 16, 16, 2009, p. 1484-1490.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Müller-Nordhorn, J, Wegscheider, K, Nolte, CH, Jungehülsing, GJ, Rossnagel, K, Reich, A, Roll, S, Villringer, A & Willich, SN 2009, 'Population-based intervention to reduce prehospital delays in patients with cerebrovascular events.', JAMA INTERN MED, vol. 169, no. 16, 16, pp. 1484-1490. <http://www.ncbi.nlm.nih.gov/pubmed/19752406?dopt=Citation>

APA

Müller-Nordhorn, J., Wegscheider, K., Nolte, C. H., Jungehülsing, G. J., Rossnagel, K., Reich, A., Roll, S., Villringer, A., & Willich, S. N. (2009). Population-based intervention to reduce prehospital delays in patients with cerebrovascular events. JAMA INTERN MED, 169(16), 1484-1490. [16]. http://www.ncbi.nlm.nih.gov/pubmed/19752406?dopt=Citation

Vancouver

Müller-Nordhorn J, Wegscheider K, Nolte CH, Jungehülsing GJ, Rossnagel K, Reich A et al. Population-based intervention to reduce prehospital delays in patients with cerebrovascular events. JAMA INTERN MED. 2009;169(16):1484-1490. 16.

Bibtex

@article{c78e18736ff642088edfa3b51b0f4431,
title = "Population-based intervention to reduce prehospital delays in patients with cerebrovascular events.",
abstract = "BACKGROUND: In patients with acute stroke, systemic thrombolysis needs to be administered within 3 hours of symptom onset. The aim of the present study was to reduce prehospital delays in a population-based intervention. METHODS: We performed a cluster-randomized trial with 48 zip code areas as cluster units in the catchment area of 3 inner-city hospitals in Berlin, Germany. The primary end point was time between symptom onset and hospital admission. The intervention consisted of an educational letter indicating stroke symptoms and emphasizing the importance of calling the emergency medical services. We additionally included a bookmark and sticker with the emergency medical services' telephone number. We fitted a series of log-normal survival regression models (time to admission) with frailty terms shared by inhabitants of the same zip code area. RESULTS: A total of 75 720 inhabitants received the intervention. Between 2004 and 2005, 741 patients with cerebrovascular events were admitted from the control areas (n = 24) and 647 from the intervention areas (n = 24). A prehospital time of 2 hours or less and 3 hours or less was achieved by 22% and 28% of patients, respectively, in the control group compared with 26% and 34%, respectively, in the intervention group. In the log-normal model, time to hospital was reduced by 27% in the intervention group in women (acceleration factor, 0.73; 95% confidence interval, 0.58-0.94), while no significant effect was found in men. CONCLUSIONS: The population-based intervention was effective in reducing prehospital delays in women but not in men. Future research should focus on the potential transferability of the intervention, its sustainability, and sex-specific impact.",
author = "Jacqueline M{\"u}ller-Nordhorn and Karl Wegscheider and Nolte, {Christian H} and Jungeh{\"u}lsing, {Gerhard J} and Karin Rossnagel and Andreas Reich and Stephanie Roll and Arno Villringer and Willich, {Stefan N}",
year = "2009",
language = "Deutsch",
volume = "169",
pages = "1484--1490",
journal = "JAMA INTERN MED",
issn = "2168-6106",
publisher = "American Medical Association",
number = "16",

}

RIS

TY - JOUR

T1 - Population-based intervention to reduce prehospital delays in patients with cerebrovascular events.

AU - Müller-Nordhorn, Jacqueline

AU - Wegscheider, Karl

AU - Nolte, Christian H

AU - Jungehülsing, Gerhard J

AU - Rossnagel, Karin

AU - Reich, Andreas

AU - Roll, Stephanie

AU - Villringer, Arno

AU - Willich, Stefan N

PY - 2009

Y1 - 2009

N2 - BACKGROUND: In patients with acute stroke, systemic thrombolysis needs to be administered within 3 hours of symptom onset. The aim of the present study was to reduce prehospital delays in a population-based intervention. METHODS: We performed a cluster-randomized trial with 48 zip code areas as cluster units in the catchment area of 3 inner-city hospitals in Berlin, Germany. The primary end point was time between symptom onset and hospital admission. The intervention consisted of an educational letter indicating stroke symptoms and emphasizing the importance of calling the emergency medical services. We additionally included a bookmark and sticker with the emergency medical services' telephone number. We fitted a series of log-normal survival regression models (time to admission) with frailty terms shared by inhabitants of the same zip code area. RESULTS: A total of 75 720 inhabitants received the intervention. Between 2004 and 2005, 741 patients with cerebrovascular events were admitted from the control areas (n = 24) and 647 from the intervention areas (n = 24). A prehospital time of 2 hours or less and 3 hours or less was achieved by 22% and 28% of patients, respectively, in the control group compared with 26% and 34%, respectively, in the intervention group. In the log-normal model, time to hospital was reduced by 27% in the intervention group in women (acceleration factor, 0.73; 95% confidence interval, 0.58-0.94), while no significant effect was found in men. CONCLUSIONS: The population-based intervention was effective in reducing prehospital delays in women but not in men. Future research should focus on the potential transferability of the intervention, its sustainability, and sex-specific impact.

AB - BACKGROUND: In patients with acute stroke, systemic thrombolysis needs to be administered within 3 hours of symptom onset. The aim of the present study was to reduce prehospital delays in a population-based intervention. METHODS: We performed a cluster-randomized trial with 48 zip code areas as cluster units in the catchment area of 3 inner-city hospitals in Berlin, Germany. The primary end point was time between symptom onset and hospital admission. The intervention consisted of an educational letter indicating stroke symptoms and emphasizing the importance of calling the emergency medical services. We additionally included a bookmark and sticker with the emergency medical services' telephone number. We fitted a series of log-normal survival regression models (time to admission) with frailty terms shared by inhabitants of the same zip code area. RESULTS: A total of 75 720 inhabitants received the intervention. Between 2004 and 2005, 741 patients with cerebrovascular events were admitted from the control areas (n = 24) and 647 from the intervention areas (n = 24). A prehospital time of 2 hours or less and 3 hours or less was achieved by 22% and 28% of patients, respectively, in the control group compared with 26% and 34%, respectively, in the intervention group. In the log-normal model, time to hospital was reduced by 27% in the intervention group in women (acceleration factor, 0.73; 95% confidence interval, 0.58-0.94), while no significant effect was found in men. CONCLUSIONS: The population-based intervention was effective in reducing prehospital delays in women but not in men. Future research should focus on the potential transferability of the intervention, its sustainability, and sex-specific impact.

M3 - SCORING: Zeitschriftenaufsatz

VL - 169

SP - 1484

EP - 1490

JO - JAMA INTERN MED

JF - JAMA INTERN MED

SN - 2168-6106

IS - 16

M1 - 16

ER -