Document Type : Original Article

Authors

1 Department of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Health in Disasters and Emergencies, Shiraz University of Medical Sciences, Shiraz, Iran

3 Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

5 Research Center for Nursing and Midwifery Care, Non communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Background: Stroke is recognized as the second leading cause of death and the primary cause of disability in developing and underdeveloped countries. This study investigated the time trend of calls for suspected stroke received by the Emergency Medical Services (EMS) from 2013 to 2019 in Shiraz, Iran.
Methods: This was a descriptive - ecological study using time series data. The necessary data were extracted from the Shiraz Emergency Medical Center from 2013 to 2019. Excel 2013 and SPSS (version 24.0) were used for data analysis. The results were then presented in figures and tables.
Results: From 2013 to 2019, the EMS call center in Shiraz City received 844,004 calls, of which 6,620 were suspected stroke cases. The number of suspected stroke cases demonstrated a steady trend within a certain range from 2013 to 2016. However, there was a significant increase between 2016 and 2017, after which the number of stroke cases reached relative stability. In the short-term seasonal trend, we found that the number of suspected stroke cases reported to EMS was higher in cold seasons compared to warm seasons.
Conclusion: The results showed that the long-term trend of reported suspected stroke cases to EMS is currently stable, following a previous increase in Iran.

Highlights

Saeed Seyfi (Google Scholar)

Khadijeh Nasiriani (Google Scholar)

Keywords

  1. Johnson W, Onuma O, Owolabi M, Sachdev S. Stroke a global response is needed. Bulletin of the World Health Organization. 2016; 94(9):634. doi: 10.2471/BLT.16.181636. PMID: 27708464.
  2. Ter-Stepanyan A, Azizian A, Gasparyan K, Ghazaryan G, English P. Assessing initial psychometric properties of the Armenian version of the Miller Forensic Assessment of Symptoms Test (M-FAST) with psychiatric patients and simulator participants. Journal of Forensic Psychology Research and Practice. 2021; 21(4):355-72. doi: 10.1080/24732850.2021.1879209.
  3. Thomas Q, Crespy V, Duloquin G, Ndiaye M, Sauvant M, Béjot Y, et al. Stroke in women: When gender matters. Revue Neurologique. 2021; 177(8):881-9. doi: 10.1016/j.neurol.2021.01.012.
  4. Collins J, Rybinnik I, Fischberg B, McCoy J. Stroke, Oxygen and Prehospital Care: A Commentary on Current Treatments and Opportunities for Improvement. Journal of Experimental Neurology. 2021; 2(1). doi: 10.33696/Neurol.2.034.
  5. Bhutta ZA, Pathan SA, Puolakka T, Akhtar N, Thomas SH, Harris T, et al. Awareness and Community Response to Stroke Signs and Symptoms Following the National ‘Act Fast’Campaign in an Ethnically Diverse Population. 2021. doi: 10.21203/rs.3.rs-798434/v1.
  6. Shinkawa A, Ueda K, Hasuo Y, Kiyohara Y, Fujishima M. Seasonal variation in stroke incidence in Hisayama, Japan. Stroke. 1990; 21(9):1262-7. doi: 10.1161/01.str.21.9.1262. PMID: 2396260.
  7. Douglas A, Allan T, Rawles J. Composition of seasonality of disease. Scottish medical journal. 1991; 36(3):76-82. doi: 10.1177/003693309103600304. PMID: 1925507.
  8. Rothwell P, Slattery J, Warlow C, Wroe S. Is stroke incidence related to season or temperature? The Lancet. 1996; 347(9006):934-6. doi: 10.1016/s0140-6736(96)91415-4. PMID: 8598757.
  9. Sobel E, Zhang Z, Alter M, Lai S, Davanipour Z, Friday G, et al. Stroke in the Lehigh Valley: seasonal variation in incidence rates. Stroke. 1987; 18(1):38-42. doi: 10.1161/01.str.18.1.38. PMID: 3810768.
  10. Biller J, Jones MP, Bruno A, Adams Jr HP, Banwart K. Seasonal variation of stroke–does it exist? Neuroepidemiology. 1988; 7(2):89-98. doi: 10.1159/000110140. PMID: 3374731.
  11. Tsementzis S, Kennet R, Hitchcock E, Gill J, Beevers D. Seasonal variation of cerebrovascular diseases. Acta neurochirurgica. 1991; 111(3):80-3. doi: 10.1007/BF01400492. PMID: 1950692.
  12. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurology. 2009;8(4):355-69. doi: 10.1016/S1474-4422(09)70025-0. PMID: 19233729.
  13. Wang W, Wang D, Liu H, Sun H, Jiang B, Ru X, et al. Trend of declining stroke mortality in China: reasons and analysis. Stroke and Vascular Neurology. 2017; 2(3). doi: 10.1136/svn-2017-000098. PMID: 28989803. PMCID: PMC5628381.
  14. Bray JE, Straney L, Barger B, Finn J. Effect of public awareness campaigns on calls to ambulance across Australia. Stroke. 2015; 46(5):1377-80. doi: 10.1161/STROKEAHA.114.008515. PMID: 25828236.
  15. Jakovljević D, Salomaa V, Sivenius J, Tamminen M, Sarti C, Salmi K, et al. Seasonal variation in the occurrence of stroke in a Finnish adult population: the FINMONICA Stroke Register. Stroke. 1996; 27(10):1774-9. doi: 10.1161/01.str.27.10.1774. PMID: 8841328.
  16. Crocco T, Grotta J, Jauch E, Kasner S, Kothari R, Larmon B, et al. EMS management of acute stroke—prehospital triage (resource document to NAEMSP position statement). Prehospital Emergency Care. 2007; 11(3):313-7. doi: 10.1080/10903120701347844. PMID: 17613906.
  17. Kolivand P-H, Faraji Sabokbar H, Saberian P, Bahmanabadi M, Hasani-Sharamin P, Baratloo A. Spatial analysis of geographic distribution and accessibility of suspected acute stroke patients transferred to acute stroke centers by emergency medical services in Tehran, Iran: a cross-sectional study. Iranian Red Crescent Medical Journal. 2020; 22(7): e101502. doi: 10.5812/ircmj.101502.
  18. Shahjouei S, Bavarsad-Shahripour R, Assarzadegan F, Rikhtegar R, Mehrpour M, Zamani B, et al. Acute management of stroke in Iran: Obstacles and solutions. Iranian journal of neurology. 2017; 16(2):62. PMID: 28761627. PMCID: PMC5526779.
  19. Esling P, Agon C. Time-series data mining. ACM Computing Surveys (CSUR). 2012; 45(1):1-34. doi: 10.1145/2379776.2379788.
  20. Asgari Q, Sarkari B, Amerinia M, Panahi S, Mohammadpour I, Sarvestani AS. Toxoplasma Infection in farm animals: a seroepidemiological survey in Fars province, south of Iran. Jundishapur Journal of Microbiology. 2013; 6(3):269-72. doi: 10.5812/jjm.5195.
  21. Iran SCo. Results of the 2016 census by city. 2016. https://irandataportal.syr.edu/wp-content/uploads/Iran_Census_2016_Selected_Results.pdf data avilibality: 1.1.2024.
  22. FARHANG A, HEMATI A. THE STUDY OF THE SEASONAL PREVALENCE OF THROMBOTIC STROKE IN WINTERS AND SUMMERS OF 1998.99 LOGMAN HAKIM HOSPITAL. 2003.
  23. Forouzanfar MM, Sepehrirad A, Heydari K, Mirbaha S. Statistical Comparison of Stroke Patients Visiting an Emergency Department During Summer Versus Winter: A Cross-Sectional Study. Archives of Neuroscience. 2020; 7(2). doi: 10.5812/ans.101946.
  24. Ogata T, Kimura K, Minematsu K, Kazui S, Yamaguchi T, Collaboration JMSI. Variation in ischemic stroke frequency in Japan by season and by other variables. Journal of the neurological sciences. 2004; 225(1-2):85-9. doi: 10.1016/j.jns.2004.07.002. PMID: 15465090.
  25. Kawahara J, Sano H, Fukuzaki H, Saito K, Hiroucht H. Acute effects of exposure to cold on blood pressure, platelet function and sympathetic nervous activity in humans. American journal of hypertension. 1989; 2(9):724-6. doi: 10.1093/ajh/2.9.724. PMID: 2529881.
  26. Terént A. Trends in stroke incidence and 10-year survival in Soderhamn, Sweden, 1975-2001. Stroke. 2003;34(6):1353-8. doi: 10.1161/01.STR.0000074038.71700.1C. PMID: 12750535.
  27. Brown RD, Whisnant JP, Sicks J, O'Fallon WM, Wiebers DO. Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989. Stroke. 1996; 27:373-80. PMID: 8610298.
  28. Numminen H, Kotila M, Waltimo O, Aho K, Kaste M. Declining incidence and mortality rates of stroke in Finland from 1972 to 1991: results of three population-based stroke registers. Stroke. 1996; 27(9):1487-91. doi: 10.1161/01.str.27.9.1487. PMID: 8784117.
  29. Morikawa Y, Nakagawa H, Naruse Y, Nishijo M, Miura K, Tabata M, et al. Trends in stroke incidence and acute case fatality in a Japanese rural area: The Oyabe study. Stroke. 2000; 31(7):1583-7. doi: 10.1161/01.str.31.7.1583. PMID: 10884458.
  30. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The lancet. 2014;383(9913):245-55. doi: 10.1016/s0140-6736(13)61953-4. PMID: 24449944. PMCID: PMC4181600.