Emergency medical services utilization in acute stroke in Qatar - an observational cohort study
Dublin Core
Title
Emergency medical services utilization in acute stroke in Qatar - an observational cohort study
Subject
Emergency medical services, Stroke, EMS utilization, Qatar
Description
Abstract
Introduction Timely recanalization improves long-term outcomes in acute ischemic stroke (IS) patients, but most
patients present outside the therapeutic window. Emergency Medical Services (EMS) can reduce pre-hospital delay
and increase the likelihood of recanalization. We aim to determine the characteristic variations amongst suspected
acute stroke patients using EMS.
Methods This retrospective observational study included all suspected acute stroke patients admitted to a national
tertiary care hospital in Qatar from January 2014 to September 2020. We evaluated demographics, clinical features,
treatment impact, and associated factors in EMS versus non-EMS transported groups.
Results During the study period, 11,892 patients presented with suspected stroke. Of these, 65.1% used EMS
(EMS group) for transportation to the hospital. Median age was comparable between EMS and non-EMS group
[52 years; IQR 43–63 vs. 43–62, p<0.05]. Male to female ratio was 3:1. EMS use in the Qatari population (59.2%) was
relatively low. Patients with hemorrhagic stroke (82.4%) had significantly higher EMS use as compared to IS (65.7%)
and cerebral venous thrombosis (64.7%); p<0.001. Symptom onset to ED presentation time was lower in EMS
users, with 41.0% arriving within 4.5 h vs. 24.3% in the non-EMS transported group (p<0.05). Patients with unilateral
weakness (66.4%), aphasia (78.2%), neglect (78.2%), dysarthria (68.4%), loss of consciousness (83.3%), and seizures
(83.9%) were more likely to use EMS than alternative modes of transportation. Patients attending via EMS had higher
rates of thrombolysis than others (82.4% vs. 17.6%; p<0.001) and a shorter door-to-needle time (56.4±38.2 min vs.
75.7±43.8 min; p<0.001).
Conclusion EMS utilization in acute stroke patients was high and was associated with rapid and higher rates of
therapeutic intervention. However, younger age, Arab ethnicity, and less obvious stroke symptoms were associated
with lower EMS use, emphasizing the need for targeted public health interventions to improve EMS activations.
Keywords Emergency medical services, Stroke, EMS utilization, Qatar
Introduction Timely recanalization improves long-term outcomes in acute ischemic stroke (IS) patients, but most
patients present outside the therapeutic window. Emergency Medical Services (EMS) can reduce pre-hospital delay
and increase the likelihood of recanalization. We aim to determine the characteristic variations amongst suspected
acute stroke patients using EMS.
Methods This retrospective observational study included all suspected acute stroke patients admitted to a national
tertiary care hospital in Qatar from January 2014 to September 2020. We evaluated demographics, clinical features,
treatment impact, and associated factors in EMS versus non-EMS transported groups.
Results During the study period, 11,892 patients presented with suspected stroke. Of these, 65.1% used EMS
(EMS group) for transportation to the hospital. Median age was comparable between EMS and non-EMS group
[52 years; IQR 43–63 vs. 43–62, p<0.05]. Male to female ratio was 3:1. EMS use in the Qatari population (59.2%) was
relatively low. Patients with hemorrhagic stroke (82.4%) had significantly higher EMS use as compared to IS (65.7%)
and cerebral venous thrombosis (64.7%); p<0.001. Symptom onset to ED presentation time was lower in EMS
users, with 41.0% arriving within 4.5 h vs. 24.3% in the non-EMS transported group (p<0.05). Patients with unilateral
weakness (66.4%), aphasia (78.2%), neglect (78.2%), dysarthria (68.4%), loss of consciousness (83.3%), and seizures
(83.9%) were more likely to use EMS than alternative modes of transportation. Patients attending via EMS had higher
rates of thrombolysis than others (82.4% vs. 17.6%; p<0.001) and a shorter door-to-needle time (56.4±38.2 min vs.
75.7±43.8 min; p<0.001).
Conclusion EMS utilization in acute stroke patients was high and was associated with rapid and higher rates of
therapeutic intervention. However, younger age, Arab ethnicity, and less obvious stroke symptoms were associated
with lower EMS use, emphasizing the need for targeted public health interventions to improve EMS activations.
Keywords Emergency medical services, Stroke, EMS utilization, Qatar
Creator
Zain A. Bhutta1,2*, Naveed Akhtar3
, Tim Harris4,5,12, Maaret Castren2
, Yahia Imam3,8, Sameer A. Pathan1,4,6,
Guillaume Alinier7,8,9,10, Saadat Kamran3
, Peter A. Cameron11 and Tuukka Puolakka2,12
, Tim Harris4,5,12, Maaret Castren2
, Yahia Imam3,8, Sameer A. Pathan1,4,6,
Guillaume Alinier7,8,9,10, Saadat Kamran3
, Peter A. Cameron11 and Tuukka Puolakka2,12
Source
https://doi.org/10.1186/s12245-025-00877-5
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Zain A. Bhutta1,2*, Naveed Akhtar3
, Tim Harris4,5,12, Maaret Castren2
, Yahia Imam3,8, Sameer A. Pathan1,4,6,
Guillaume Alinier7,8,9,10, Saadat Kamran3
, Peter A. Cameron11 and Tuukka Puolakka2,12, “Emergency medical services utilization in acute stroke in Qatar - an observational cohort study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12763.