J Korean Med Sci.  2021 Dec;36(48):e327. 10.3346/jkms.2021.36.e327.

Prehospital Notification Using a Mobile Application Can Improve Regional Stroke Care System in a Metropolitan Area

Affiliations
  • 1Department of Emergency Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
  • 2Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
  • 3Department of Neurology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
  • 4Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
  • 5Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Korea
  • 6Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea
  • 7Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea

Abstract

Background
Acute ischemic stroke is a time-sensitive disease. Emergency medical service (EMS) prehospital notification of potential patients with stroke could play an important role in improving the in-hospital medical response and timely treatment of patients with acute ischemic stroke. We analyzed the effects of FASTroke, a mobile app that EMS can use to notify hospitals of patients with suspected acute ischemic stroke at the prehospital stage.
Methods
We conducted a retrospective observational study of patients diagnosed with acute ischemic stroke at 5 major hospitals in metropolitan Daegu City, Korea, from February 2020 to January 2021. The clinical conditions and time required for managing patients were compared according to whether the EMS employed FASTroke app and further compared the factors by dividing the patients into subgroups according to the preregistration received by the hospitals when using FASTroke app.
Results
Of the 563 patients diagnosed with acute ischemic stroke, FASTroke was activated for 200; of these, 93 were preregistered. The FASTroke prenotification showed faster door-tocomputed-tomography times (19 minutes vs. 25 minutes, P < 0.001), faster door-to-intravenousthrombolysis times (37 minutes vs. 48 minutes, P < 0.001), and faster door-to-endovascularthrombectomy times (82 minutes vs. 119 minutes, P < 0.001). The time was further shortened when the preregistration was conducted simultaneously by the receiving hospital.
Conclusion
The FASTroke app is an easy and useful tool for prenotification as a regional stroke care system in the metropolitan area, leading to reduced transport and acute ischemic stroke management time and more reperfusion treatment. The effect was more significant when the preregistration was performed jointly.

Keyword

Stroke; Thrombolytic Therapy; Emergency Medical Services
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