A cohort study: The association between prehospital care and in-hospital treatment decisions in acute stroke
from James P. Sheppard, Ruth M. Mellor, Sheila Greenfield, et al.
Stroke causes an estimated 5.7 million deaths worldwide and the loss of approximately 50 million disability-adjusted life years every year. The burden of stroke can be reduced with thrombolytic treatment using alteplase, but the time window for safe and effective treatment is short: thrombolysis is effective at improving functional outcome if administered up to six hours following symptom onset. Access to thrombolysis requires timely arrival at hospital, followed by urgent assessment, including brain imaging, to exclude intracranial haemorrhage.
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