An Association Between Systolic Blood Pressure and Stroke Among Patients With Impaired Consciousness in Out-of-Hospital Emergency Settings

Taro Irisawa; Taku Iwami; Tetsuhisa Kitamura; Chika Nishiyama; Tomohiko Sakai; Kayo Tanigawa-Sugihara; Sumito Hayashida; Tatsuya Nishiuchi; Tadahiko Shiozaki; Osamu Tasaki; Takashi Kawamura; Atsushi Hiraide; Takeshi Shimazu


BMC Emerg Med. 2013;13(24) 

In This Article


Stroke is an important public health problem in the industrialized world[1] and there are 300,000 estimated strokes encounter in the prehospital settings annually Japan.[2] To improve neurologic outcomes after stroke, earlier identification and treatment is most important, but it takes longer time for EMS personnel to transport emergency stroke patients to the stroke centers if EMS personnel could not appropriately recognize these patients.[3] If EMS personnel can discriminate patients with stroke in prehospital settings, these patients can be transported fast to appropriate hospitals that offer advanced treatments such as thrombolytic therapy and interventional radiology.

Importantly, it is difficult to assess neurological findings such as paralysis of stroke in patients with impaired consciousness, and an alternative way to select these patients would, therefore, be needed. Although a lot of studies have showed the positive association between systolic blood pressure (SBP) and the risk of stroke occurrence,[4] little is known about the relationship between SBP measured by EMS personnel and the risk of stroke occurrence among patients with impaired consciousness.

Osaka City is a largest urban community in western Japan with approximately 2.7 million population, and approximately 200,000 ambulance runs documented annually since January 1998. The purpose of this study was to evaluate the relationship between SBP measured by EMS in prehospital settings and stroke occurrence among emergency patients with impaired consciousness.