Evaluation Of The Application Of The Hohhot Stroke Emergency Map In The Efficiency Of Treatment Of Ischemic Stroke Patients

Objective The Hohhot Stroke Emergency Map was used to analyse whether the Hohhot Stroke Emergency Map could improve pre-hospital delay,in-hospital delay,increase thrombolysis rates and improve prognosis(3-month m RS)in patients with acute ischaemic stroke(AIS)attending neurology department of Inner Mongolia People’s Hospital before and after the release of the Hohhot Stroke Emergency Map,and to analyse the pre-hospital delay and The study also analysed the factors influencing pre-hospital delay and prognosis.The study will provide a basis for the development of pre-hospital care for AIS patients in Hohhot in the acute phase,and for the scientific validity of the Stroke Emergency Map in Inner Mongolia Autonomous Region.Methods From November 2021 to November 2022,638 patients with AIS who visited the neurology department of Inner Mongolia People’s Hospital was consecutively collected and divided into two groups at the time of the release of the Hohhot Stroke Emergency Map(27July 2022).406 patients before the release of the Stroke Emergency Map were set as the control group and 232 patients after the release of the Stroke Emergency Map were set as the observation group.Baseline and clinical data were recorded and differences between the two groups were compared.Factors affecting onset-to-door time(ODT)were analysed by multiple linear regression and factors affecting prognosis(3-month m RS)were analysed by binary logistic regression.Results1.Baseline data: There were no statistical differences between the control and observation groups in the comparison of baseline data such as age,gender,education,type of residence,distance from hospital,first symptoms,mode of arrival,first NIHSS on admission,pre-onset m RS,first m RS on admission,smoking,alcohol consumption,hypertension,diabetes,previous history of ischaemic stroke and atrial fibrillation,P>0.05.2.Clinical data: There was a statistically significant difference between the control group and the observation group in the comparison of ODT,NIHSS at discharge,3-month m RS,3-month m RS 0-2 score,proportion of NIHSS better >46% at discharge and thrombolysis rate,P < 0.05.There was no statistically significant difference in the comparison of door-to-needle time(DNT)between the two groups.There was no statistically significant difference in door-to-needle time(DNT)between the two groups,P>0.05.3.Analysis of factors affecting ODT: Multiple linear regression analysis with the patient’s ODT marker as the dependent variable and gender,age,education,first symptoms,type of residence,mode of transport,distance from hospital,smoking,alcohol consumption,hypertension,diabetes,ischaemic stroke and history of atrial fibrillation markers as independent variables showed that the factors affecting ODT were age,distance from hospital,mode of transport and having diabetes,P< 0.05.4.Analysis of factors affecting 3-month m RS: good prognosis(m RS score 0-2)was marked as 0,poor prognosis(m RS score 3-5)was marked as 1 and recorded as the dependent variable,age,education,first symptom,type of residence,ODT,DNT,mode of transport,distance from hospital,thrombolysis,smoking,alcohol consumption,hypertension,diabetes,ischaemic stroke and history of atrial fibrillation were marked as the independent variables,using binary The results of logistic regression analysis showed that the first symptom was limb weakness,hypertension was more likely to have a poor prognosis,and the older the age,the more likely it was to have a poor prognosis,P < 0.05.The ROC curve for age and3-month m RS in patients with AIS was plotted and the area under the curve(AUC)was 0.626,with the best cut-off value for age being 76.5 years(sensitivity: 33.3%,specificity: 88.0%).Conclusion1.The release of the Hohhot Stroke Emergency Map further demonstrates that the Stroke Emergency Map can shorten the time to visit AIS patients,improve pre-hospital delays for AIS patients,increase thrombolysis rates and improve prognosis,providing a basis for the development of pre-hospital treatment and stroke emergency maps for the acute phase of AIS in Hohhot and Inner Mongolia Autonomous Region.2.Age,distance from hospital,transport route,and having diabetes affect the pre-hospital delay of AIS patients;first symptoms,hypertension and age affect the short-term prognosis of AIS patients.The study also provides a reference for future efforts to reduce pre-hospital delays and improve prognosis of AIS patients in Hohhot.Control of risk factors for AIS,early screening and primary prevention of AIS,promotion of stroke symptom recognition,time window for treatment and ambulance transport are essential.