Call-taker recognition of stroke and TIA in emergency calls in Region Zealand, Denmark

Résumé fourni par la source

Rapid recognition of stroke/transient ischaemic attack (TIA) in the emergency telephone is crucial to ensure timely intervention and direct transport to stroke centres. Our study investigated the diagnostic accuracy via the 1-1-2 emergency line (1-1-2) call-takers in Region Zealand, Denmark, and examined whether recognised cases had a higher chance of referral to a primary stroke centre and receiving thrombolysis. We retrospectively analysed calls linked to hospital discharge codes for stroke/TIA. Call-taker stroke/TIA suspicion was documented. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Additionally, we calculated the relative risk of receiving intravenous thrombolysis and direct stroke-centre transport for recognised versus unrecognised calls. Among 196,235 calls to 1-1-2 from 2021 to 2024, 2581 patients had confirmed stroke/TIA. Dispatcher sensitivity was 0.75, with a PPV of 0.18. Recognised patients compared to unrecognised cases had a higher chance of direct admissions to primary stroke units with a RR of 1.46 (95% CI = 1.38;1.54) and a higher chance of receiving thrombolysis with a RR of 1.43 (95% CI = 1.12;1.82). Correct call-taker recognition of stroke/TIA was significantly associated with improved acute management, chance of thrombolysis and correct hospital pathway. A substantial proportion of stroke cases remain unrecognised. Enhanced decision-support tools could potentially improve call-taker performance and patient outcomes in Region Zealand.

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