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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. Methods: 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. Results: 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. 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An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings
http://hdl.handle.net/10069/34070
http://hdl.handle.net/10069/3407098b3cb00-7cbf-41b6-9a80-088b48bc72be
名前 / ファイル | ライセンス | アクション |
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BMCEM13_24.pdf (292.5 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2014-01-24 | |||||
タイトル | ||||||
タイトル | An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Impaired consciousness | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Prehospital | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Systolic blood pressure | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Irisawa, Taro
× Irisawa, Taro× Iwami, Taku× Kitamura, Tetsuhisa× Nishiyama, Chika× Sakai, Tomohiko× Tanigawa-Sugihara, Kayo× Hayashida, Sumito× Nishiuchi, Tatsuya× Shiozaki, Tadahiko× Tasaki, Osamu× Kawamura, Takashi× Hiraide, Atsushi× Shimazu, Takeshi |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: 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. Methods: 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. Results: 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 SBP group to 27.6% in the > =200 mmHg SBP group (P for trend <0.001). The occurrence of stroke significantly increased with increasing SBP (adjusted odd ratio [AOR] 1.34, 95% confidence interval [CI] 1.33 to 1.35), and the AOR of the SBP > =200 mmHg group versus the SBP 101-120 mmHg group was 5.26 (95% CI 4.93 to 5.60). The AOR of the SBP > =200 mmHg group versus the SBP 101-120 mmHg group was 9.76 in subarachnoid hemorrhage (SAH), 16.16 in intracranial hemorrhage (ICH), and 1.52 in ischemic stroke (IS), and the AOR of SAH and ICH was greater than that of IS. Conclusions: Elevated SBP among emergency patients with impaired consciousness in the field was associated with increased diagnosis of stroke. | |||||
書誌情報 |
BMC Emergency Medicine 巻 13, 号 1, p. 24, 発行日 2013-12-17 |
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出版者 | ||||||
出版者 | BioMed Central | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1471227X | |||||
DOI | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1186/1471-227X-13-24 | |||||
権利 | ||||||
権利情報 | c 2013 Irisawa et al.; licensee BioMed Central Ltd. | |||||
権利 | ||||||
権利情報 | This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | BMC Emergency Medicine, 13(1), 24; 2013 |