Abstract

Background:
Suspected stroke is a common scenario amongst care home residents, who are typically older and have more complex health needs than the general population.

Aims:
The aim of this study was to describe the care of suspected stroke patients according to their residential status.

Methods:
Retrospective secondary analysis of an existing ambulance clinical record dataset from a UK ambulance service, describing the care of patients labelled as suspected stroke between December 2021 and April 2022.

Findings:
Care home patients were older (median 86 (IQR 79-91) years versus 75 (IQR 63-83) years; p= <0.001), with more comorbidities (median 5 (IQR 3-6) versus median 3 (IQR 2-5); p= <0.001) and medications (median 6 (IQR 4-9) versus median 4 (IQR 1-7); p= <0.001). They were more likely to have difficulties completing the Face Arms Speech Test (17/170 (10%) versus 39/1305 (3%); p=<0.001) and present with facial droop (85/153 (55.6%) versus 506/1266 (40%); p=<0.001). Ambulance on-scene time was longer at care homes (median 41 (IQR 32-49.5) minutes versus median 35 (IQR 27-45) minutes; p =<0.001).

Conclusion:
Clinician awareness of characteristics associated with residential settings may be important for delivering emergency stroke care. Research is needed to optimise ambulance assessment for care home patients.