The application of pre-hospital first aid mode in patients with acute stroke: meta-analysis

To systematically evaluate the application effect of pre-hospital and in-hospital emergency mode in patients with acute stroke.

The study was conducted by systematic search of Chinese (CNKI, Wanfang and VIP) and English (PubMed, EMBASE and Cochrane Library) databases. The case-control studies comparing the role of pre-hospital and in-hospital emergency mode for patients with acute stroke were included in this study. Outcome indicators included the time from admission to thrombolytic therapy (DNT), the time from calling for help to receiving professional treatment, the first aid effect (effective rate, disability rate and mortality), complications and prognosis. Meta-analysis was performed using RevMan 5.3.

Seventeen studies were included in the final analysis. Compared with traditional emergency measures, pre-hospital and in-hospital emergency measures can significantly reduce DNT (mean difference [MD] = –22.63, p < 0.00001), time from call to professional treatment (MD: –13.22, p < 0.00001), disability rate (RR = 0.88, p = 0.004), fatality rate (RR = 0.58, p < 0.00001), central cerebral fever (RR = 0.44, p = 0.0009), and gastrointestinal bleeding (RR = 0.44, p = 0.002). In addition, daily living ability (MD = 16.56, p < 0.00001) and emergency response rate (RR = 1.50, p < 0.00001) were significantly improved.

The pre-hospital and in-hospital emergency mode has a significant emergency effect in patients with acute stroke, which is a protective factor. This emergency mode can be widely used in clinical practice.