Introduction

In the fight against acute ischemic stroke (IS), every second counts! Rapid recanalization significantly improves long-term patient outcomes, yet many patients arrive at medical facilities too late for effective treatment. Emergency Medical Services (EMS) can bridge this crucial gap by reducing pre-hospital delays and enhancing the chances of timely recanalization. This study investigates variations in the characteristics of suspected acute stroke patients who utilize EMS in Qatar, aiming for a deeper understanding that could inform public health strategies.

Methods

This comprehensive observational study analyzed data from suspected acute stroke patients admitted between January 2014 and September 2020 at a major national tertiary hospital in Qatar. It assessed demographics, clinical features, treatment impacts, and various factors distinguishing EMS users from those using other transportation methods.

Key Findings

A staggering 11,892 patients sought treatment for suspected strokes during the study period. Of these, 7,734, or 65.1%, arrived via EMS. The median age in the EMS group was notably younger, indicating demographic variances, with a male-to-female ratio of 3:1. Interestingly, only 59.2% of suspected stroke patients utilized EMS, underscoring the need for increased awareness about the importance of immediate medical assistance.

Furthermore, patients presenting with hemorrhagic strokes were more likely to use EMS compared to those with IS and cerebral venous thrombosis—82.4% versus 65.7% and 64.7%, respectively. The urgency in symptom recognition was evident; EMS users were considerably quicker to reach the emergency department, with 41.0% arriving within 4.5 hours compared to 24.3% of non-EMS users.

Notably, patients exhibiting critical symptoms—such as unilateral weakness or loss of consciousness—were more inclined to rely on EMS. The treatment outcomes reflected this urgency: those arriving via EMS were significantly more likely to receive thrombolysis (82.4% vs. 17.6%) and experienced faster door-to-needle times (56.4 minutes compared to 75.7).

Conclusion

The utilization of EMS for acute stroke patients in Qatar is notably high and correlated with expedited treatment, showcasing how effective EMS can facilitate better patient outcomes. However, a concerning trend emerged: younger individuals, Qatari nationals, and those displaying less conspicuous stroke symptoms tended to underutilize EMS services. This finding highlights the urgent need for targeted public health initiatives to increase awareness and enhance EMS activations, ultimately leading to improved intervention rates and patient outcomes.

Broader Implications and Future Directions

Globally, stroke remains one of the leading causes of death and disability. In Qatar, around 70-80% of strokes are ischemic, and timely intervention is critical. Public health campaigns that educate citizens on recognizing stroke symptoms and the importance of immediate EMS activation could dramatically alter treatment trajectories.

Interestingly, a campaign in 2015 in Qatar reported that only 20.1% of participants recognized stroke symptoms, stressing the necessity for ongoing educational efforts. Increased engagement through initiatives like the “Act FAST” campaign can elevate awareness about stroke signs and the importance of rapid EMS response.

In the context of ongoing healthcare challenges, such as those posed by the COVID-19 pandemic, the findings suggest a need for adaptable strategies to maintain high levels of EMS engagement without compromising treatment quality. Insights regarding demographic variations in EMS usage can help design interventions tailored to specific groups, ultimately leading to better healthcare delivery for all Qataris.

As we analyze trends, it’s clear that continuous efforts to understand and address the gaps in EMS utilization will pave the way for improved stroke management and better health outcomes, not just in Qatar but across regions combating similar challenges.