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ACS: Patients Can Be Evaluated for Stroke and Trauma With STRAUMA Alert

While the approach adds a few minutes for time to CT, there was no impact on start of treatment

WEDNESDAY, Nov. 3, 2021 (HealthDay News) — The novel STRAUMA alert activation allows for expedited evaluation of both stroke and trauma, according to a study presented at the annual meeting of the American College of Surgeons, held virtually from Oct. 23 to 27.

Janet S. Lee, M.D., from the University of Colorado in Aurora, and colleagues evaluated the impact of the STRAUMA alert, a combined stroke and highest-level trauma activation for patients with suspected cerebrovascular accident and signs of trauma, on patient outcomes. The analysis included a retrospective review of 580 patients with signs of cerebrovascular accident from January 2019 to September 2020 (111 had a STRAUMA alert and 469 had a stroke alert).

The researchers found that The STRAUMA group had a higher National Institutes of Health Stroke Scale score (NIHSS). The stroke group had a shorter time to computed tomography (CT; 16.9 versus 23.1 minutes) and a higher rate of tissue plasminogen activator administration (tPA; 27.3 versus 12.5 percent). Time to tPA was similar in both groups. Traumatic injury was seen in 15 percent of the STRAUMA group, with a median injury severity score of 9 in those with injuries. The STRAUMA group had higher mortality (14.4 versus 6.0 percent). NIHSS and time to CT were identified as predictors of mortality.

“It’s all about risk versus benefit,” said Lee in a statement. “The risk of patients with trauma getting tPA and having catastrophic bleeding outweighs the risk of a slight delay in CT scanning. And our results ultimately show that in all patients who did get tPA, no differences were seen in time-to-tPA.”

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