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Stroke Code Transports by Emergency Medical Services: Positive Predictive Value and Therapeutic Decisions in a Large Finnish Province.

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Title: Stroke Code Transports by Emergency Medical Services: Positive Predictive Value and Therapeutic Decisions in a Large Finnish Province.
Authors: Wikman, Kristina (AUTHOR), Puolakka, Tuukka (AUTHOR), Räty, Silja (AUTHOR), Kuisma, Markku (AUTHOR), Strbian, Daniel (AUTHOR), Abdullah, Jafri Malin (AUTHOR)
Source: Acta Neurologica Scandinavica. 2/6/2026, Vol. 2026, p1-8. 8p.
Subjects: Cerebrovascular disease, Emergency medical services, Health equity, Ischemic stroke, Thrombolytic therapy, Diagnosis, Stroke
Abstract: Background and Aims: Precise prehospital identification of cerebrovascular diseases (CVD) is essential for timely decisions concerning recanalization therapy for acute ischemic stroke (IS). This study described the stroke chain by analyzing patients transported by emergency medical services (EMS) with a stroke code, focusing on the EMS process regarding both CVD recognition and final recanalization decisions. Methods: This retrospective, population‐based, observational study analyzed all consecutive patients transported by EMS with suspected acute CVD in the Helsinki University Hospital service area during a 4‐month period, irrespective of transport priority or receiving hospital. Prehospital and hospital patient records were combined, and the cohort was cross‐checked with the database of given recanalization therapies. Sex‐related and regional differences were assessed. Results: Out of 1411 transports, 702 (50%) CVD diagnoses were identified. Of 521 high‐priority transports, 317 (61%) received a CVD diagnosis and 98 (19%) recanalization therapy. Any recanalization therapy was given to 97/415 (23%) IS patients and to 91/211 (43%) IS patients transported with high priority. There were no significant sex‐related or regional differences concerning diagnostic accuracy or treatment decisions. Altogether, 92% of the EMS transports ultimately leading to recanalization therapy were assigned high‐priority stroke code. Conclusions: The Finnish EMS system seems relatively accurate in identifying cerebrovascular disease; of all stroke‐code transports, every second patient received a CVD diagnosis. Of the high‐priority transports, 19% led to recanalization decisions. We observed no signs of gender or regional inequity. Most patients who received recanalization therapy were correctly identified by the EMS and transported with high priority, but this inevitably came at the expense of specificity. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Stroke Code Transports by Emergency Medical Services: Positive Predictive Value and Therapeutic Decisions in a Large Finnish Province.
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  Data: <searchLink fieldCode="AR" term="%22Wikman%2C+Kristina%22">Wikman, Kristina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Puolakka%2C+Tuukka%22">Puolakka, Tuukka</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Räty%2C+Silja%22">Räty, Silja</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kuisma%2C+Markku%22">Kuisma, Markku</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strbian%2C+Daniel%22">Strbian, Daniel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Abdullah%2C+Jafri+Malin%22">Abdullah, Jafri Malin</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. 2/6/2026, Vol. 2026, p1-8. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Cerebrovascular+disease%22">Cerebrovascular disease</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medical+services%22">Emergency medical services</searchLink><br /><searchLink fieldCode="DE" term="%22Health+equity%22">Health equity</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemic+stroke%22">Ischemic stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombolytic+therapy%22">Thrombolytic therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and Aims: Precise prehospital identification of cerebrovascular diseases (CVD) is essential for timely decisions concerning recanalization therapy for acute ischemic stroke (IS). This study described the stroke chain by analyzing patients transported by emergency medical services (EMS) with a stroke code, focusing on the EMS process regarding both CVD recognition and final recanalization decisions. Methods: This retrospective, population‐based, observational study analyzed all consecutive patients transported by EMS with suspected acute CVD in the Helsinki University Hospital service area during a 4‐month period, irrespective of transport priority or receiving hospital. Prehospital and hospital patient records were combined, and the cohort was cross‐checked with the database of given recanalization therapies. Sex‐related and regional differences were assessed. Results: Out of 1411 transports, 702 (50%) CVD diagnoses were identified. Of 521 high‐priority transports, 317 (61%) received a CVD diagnosis and 98 (19%) recanalization therapy. Any recanalization therapy was given to 97/415 (23%) IS patients and to 91/211 (43%) IS patients transported with high priority. There were no significant sex‐related or regional differences concerning diagnostic accuracy or treatment decisions. Altogether, 92% of the EMS transports ultimately leading to recanalization therapy were assigned high‐priority stroke code. Conclusions: The Finnish EMS system seems relatively accurate in identifying cerebrovascular disease; of all stroke‐code transports, every second patient received a CVD diagnosis. Of the high‐priority transports, 19% led to recanalization decisions. We observed no signs of gender or regional inequity. Most patients who received recanalization therapy were correctly identified by the EMS and transported with high priority, but this inevitably came at the expense of specificity. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1155/ane/9677875
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      – Code: eng
        Text: English
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        PageCount: 8
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      – SubjectFull: Cerebrovascular disease
        Type: general
      – SubjectFull: Emergency medical services
        Type: general
      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Ischemic stroke
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      – SubjectFull: Thrombolytic therapy
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      – SubjectFull: Diagnosis
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      – SubjectFull: Stroke
        Type: general
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      – TitleFull: Stroke Code Transports by Emergency Medical Services: Positive Predictive Value and Therapeutic Decisions in a Large Finnish Province.
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              Text: 2/6/2026
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              Y: 2026
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