Triage of stroke patients in the chain of acute stroke care

By advancing existing stroke triage systems, diagnosis and timely access of stroke patients to specialized care can be improved, which in turn can have a tremendous impact on current clinical practice. The overall aim of this thesis was to assess various ways to improve stroke triage in the chain of acute stroke. To begin with patient triage by assessing the patient’s entrance into the chain of acute stroke care (Part I). To improve patient triage, the focus should be to directly involve the ambulance once stroke is suspected. In Part II, prehospital triage tools to improve patient selection in the ambulance are identified en validated. Prehospital triage tools that can help identify patients who are more likely to have large anterior vessel occlusion or can differentiate between patients with acute ischemic stroke and intracerebral hemorrhage, will improve patient selection in the ambulance and thereby result in earlier initiation of endovascular treatment, thereby improving patient outcomes. In the last part (Part III), in-hospital factors are investigated that are known to have an adverse effect on patient outcome in the final part of the chain of acute stroke care, as continued efforts need to be made to further reduce in-hospital delays.The Dutch Heart FoundationLUMC / Geneeskund