Demographic analysis of patients applied to A stroke center and evaluation of the effectiveness of the fast-ed (Field assessment stroke triage for emergency destination) score

INTRODUCTION AND AIM: Stroke is one of the most common causes of morbidity and mortality. The first application place for stroke cases is emergency services. Reversible ischemic brain damage can be avoided with rapid diagnosis and treatment in the right place. The aim of this study is; knowing that healthcare professionals and physicians who will recognize stroke in the field are competing over time for the application of new neuron-saving treatment methods such as thrombolytic and thrombectomy; to recognize the patient and to examine the effectiveness of scoring systems and classifications, which are used to direct them quickly for appropriate treatment. MATERIALS AND METHODS: In our study, 327 patients who were admitted to the emergency department of Dicle University between 20.08.2018 and 31.08.2019 and hospitalized with the diagnosis of stroke were examined. These patients were grouped according to the FAST-ED (Field Assessment Stroke Triage For Emergency Destination) score, which is an uncomplicated scale that can be used practically by emergency medical technicians in the field ambulance team. We divided the patients into 3 groups according to the FAST-ED score as low risk (0-1), medium risk (2-3) and high risk (≥4).Results are given as mean±SD. Univariate statistical analyzes were performed using chi-square test for categorical variables and student-t test for continuous variables. In the comparisons within the group, since the groups did not show a normal distribution and the number of subjects in the groups were not equal, Kruskal Wallis one-way analysis of variance and MannWhitney U test were used as multiple comparison methods. In comparisons between the groups, p<0.01; In other comparisons, p <0.05 was considered statistically significant. RESULTS: After the patients who were excluded from the study for various reasons, 163 patients were included in our study. The average age of the patients was 64.78±14.57, 91 men and 72 women. When the patients were examined during the day, the most common admission was in the morning hours (33.7%) and the seasonal was in the winter season (38.6%). The most common comorbid diseases in patients were hypertension (53.3%), coronary artery disease(30.6%) and diabetes mellitus(26.3%) respectively. We determined that hemiparesis (51.5%), speech disorder (46.6%) and consciousness and awareness change (22.6%) were the top 3 reasons for application. in the laboratory parameters, NLR values according to FAST-ED scores was FAST-ED 1 (2.74 ± 1.11), FAST-ED 2 (5.12 ± 3.47), FAST-ED 3 (6.21 ± 3.53). We determined arrival times as FAST-ED 1 (8.36 ± 6.72), FASTED 2 (6.52 ± 4.91), FAST-ED 3 (4.93 ± 4.25) hours. 31.2% of the patients in FAST-ED 2- v 3(medium-high risk); It was observed that 52.2% of the patients in FAST-ED 1(low risk) were admitted as outpatient application on their own.Thrombolytic was performed in 15.6% of all patients. While 26% of FAST-ED 2-3 group patients underwent thrombolytic therapy, only 1.49% of FAST-ED 1 group patients were performed. CONCLUSION: In the FAST-ED 1(low risk) group; The duration of admission was longer, more outpatient admissions, less thrombolytics were given, large vessel occlusion(LVOS), extensive ischemia and mortality were found to be less, and in laboratory parameters lower NLR were found. As the FAST-ED score of the patient increases, the size of the brain region involved, the need for thrombolytic referral and mortality increase.