Abstract
Background
It is speculated that there is overlap between neurologic emergencies and trauma,
yet to date there has not been a study looking at the prevalence of neurologic emergencies
amongst trauma activations.
Objectives
We sought to determine the prevalence of neurologic emergencies in patients presenting
to a level I trauma center as trauma team activations (TTAs). We explored a subset
of acute ischemic stroke patients to determine delays in management.
Methods
This was a retrospective review of trauma registry data capturing all TTAs at a level
I trauma and stroke center from 2011 to 2016. Neurologic emergencies were defined
as ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, or status epilepticus.
Among patients diagnosed with acute ischemic strokes, we compared stroke metrics with
hospital stroke data during the same period.
Results
There were 18,859 trauma activations during the study period, of which 117 (0.6%)
had a neurologic emergency. There were 52 patients with ischemic stroke (45%), 39
with intracerebral hemorrhage (34%), 15 with subarachnoid hemorrhage (13%), and 10
with status epilepticus (9%). Among the 52 patients with ischemic stroke, 20 (38%)
received intravenous thrombolysis. The median time to computed tomography scan was
23 min and the median time to thrombolysis (tissue plasminogen activator) was 60 min.
When compared with non-TTA patients during the same time period, both median time
to computed tomography scan and time to tissue plasminogen activator were similar
(p = 0.16 and p = 0.6, respectively).
Conclusions
Neurologic emergencies, though relatively uncommon, do exist among TTAs. Despite the
TTA, eligible patients met the benchmarks for acute stroke care delivery.
Keywords
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Article info
Publication history
Published online: July 31, 2019
Accepted:
May 6,
2019
Received in revised form:
April 6,
2019
Received:
September 17,
2018
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
