BACKGROUND AND OBJECTIVE: This observational study describes the time delays involved in the emergency treatment of acute strokes admitted for treatment in the acute stroke unit of the Landesnervenklinik Gugging, Austria. The aim was to define avoidable delays in the prehospital and intrahospital phase. PATIENTS AND METHODS: 261 stroke patients were included consecutively within the one-year study period (September 1996 until September 1997). Minute-by-minute reconstruction of events starting from the first symptoms to the first therapeutic application within the stroke unit was performed for every stroke patient by a neurologist during or immediately after treatment. RESULTS: Time delays are predominantly in the prehospital phase. Only 20.5% are admitted within 120 minutes after noticing first symptoms. Public registration time was 42 +/- 212 minutes. In the intrahospital phase, the mean door-to-drug-time was 50 +/- 28 minutes (including CT). In 25% of the patients, adequate treatment of acute stroke was started within 35 minutes after the patient's arriving at the hospital. In 92% cerebral computed tomography was performed before treatment was started. CONCLUSIONS: This study shows the necessity for continuing efforts to increase public awareness for immediate hospitalisation after stroke in order to achieve a higher rate of urgent and direct admission to a stroke unit.
BACKGROUND AND OBJECTIVE: This observational study describes the time delays involved in the emergency treatment of acute strokes admitted for treatment in the acute stroke unit of the Landesnervenklinik Gugging, Austria. The aim was to define avoidable delays in the prehospital and intrahospital phase. PATIENTS AND METHODS: 261 strokepatients were included consecutively within the one-year study period (September 1996 until September 1997). Minute-by-minute reconstruction of events starting from the first symptoms to the first therapeutic application within the stroke unit was performed for every strokepatient by a neurologist during or immediately after treatment. RESULTS: Time delays are predominantly in the prehospital phase. Only 20.5% are admitted within 120 minutes after noticing first symptoms. Public registration time was 42 +/- 212 minutes. In the intrahospital phase, the mean door-to-drug-time was 50 +/- 28 minutes (including CT). In 25% of the patients, adequate treatment of acute stroke was started within 35 minutes after the patient's arriving at the hospital. In 92% cerebral computed tomography was performed before treatment was started. CONCLUSIONS: This study shows the necessity for continuing efforts to increase public awareness for immediate hospitalisation after stroke in order to achieve a higher rate of urgent and direct admission to a stroke unit.