An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings

BMC Emergency Medicine
Taro IrisawaTakeshi Shimazu

Abstract

Stroke is difficult to diagnose when consciousness is disturbed. However few reports have discussed the clinical predictors of stroke in out-of-hospital emergency settings. This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and diagnosis of stroke among impaired consciousness patients. We included all patients aged 18 years or older who were treated and transported by EMS, and had impaired consciousness (Japan Coma Scale ≧ 1) in Osaka City (2.7 million), Japan from January 1, 1998 through December 31, 2007. Data were prospectively collected by EMS personnel using a study-specific case report form. Multiple logistic regressions assessed the relationship between initial SBP and stroke and its subtypes adjusted for possible confounding factors. During these 10 years, a total of 1,840,784 emergency patients who were treated and transported by EMS were documented during the study period in Osaka City. Out of 128,678 with impaired consciousness, 106,706 who had prehospital SBP measurements in the field were eligible for our analyses. The proportion of patients with severe impaired consciousness significantly increased from 14.5% in the <100 mmHg ...Continue Reading

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Citations

Sep 4, 2014·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Tomohiko SakaiTakeshi Shimazu
Nov 11, 2015·Internal and Emergency Medicine·Mohit SharmaEthan Samuel Brandler
May 20, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Kosuke KiyoharaTetsuhisa Kitamura
Apr 5, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Gelareh Z GabayanCatherine A Sarkisian
Mar 16, 2018·Stroke; a Journal of Cerebral Circulation·Stephen van Gaal, Andrew Demchuk

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