OBJECTIVE: To investigate delays in the presentation to hospital and evaluation of patients with suspected stroke. DESIGN: Multicentre prospective observational study. SETTING: 22 hospitals in the United Kingdom and Dublin. PARTICIPANTS: 739 patients with suspected stroke presenting to hospital. MAIN OUTCOME MEASURES: Time from onset of stroke symptoms to arrival at hospital, and time from arrival to evaluation by a senior doctor. RESULTS: The median age of patients was 75 years, and 400 were women. The median delay between onset of symptoms and arrival at hospital was 6 hours (interquartile range 1 hour 48 minutes to 19 hours 12 minutes). 37% of patients arrived within 3 hours, 50% within 6 hours. The median delay for patients using the emergency service was 2 hours 3 minutes (47 minutes to 7 hours 12 minutes) compared with 7 hours 12 minutes (2 hours 5 minutes to 20 hours 37 minutes) for referrals from general practitioners (P<0.0001). Use of emergency services reduced delays to hospital (odds ratio 0.45, 95% confidence interval 0.23 to 0.61). The median time to evaluation by a senior doctor was 1 hour 9 minutes (interquartile range 33 minutes to 1 hour 50 minutes) but was undertaken in only 477 (65%) patients within 3 hours of arrival. This was not influenced by age, sex, time of presentation, mode of referral, hospital type, or the presence of a stroke unit. Computed tomography was requested within 3 hours of arrival in 166 (22%) patients but undertaken in only 60 (8%). CONCLUSION: Delays in patients arriving at hospital with suspected stroke can be reduced by the increased use of emergency services. Over a third of patients arrive at hospital within three hours of stroke; their management can be improved by expediting medical evaluation and performing computed tomography early.
OBJECTIVE: To investigate delays in the presentation to hospital and evaluation of patients with suspected stroke. DESIGN: Multicentre prospective observational study. SETTING: 22 hospitals in the United Kingdom and Dublin. PARTICIPANTS: 739 patients with suspected stroke presenting to hospital. MAIN OUTCOME MEASURES: Time from onset of stroke symptoms to arrival at hospital, and time from arrival to evaluation by a senior doctor. RESULTS: The median age of patients was 75 years, and 400 were women. The median delay between onset of symptoms and arrival at hospital was 6 hours (interquartile range 1 hour 48 minutes to 19 hours 12 minutes). 37% of patients arrived within 3 hours, 50% within 6 hours. The median delay for patients using the emergency service was 2 hours 3 minutes (47 minutes to 7 hours 12 minutes) compared with 7 hours 12 minutes (2 hours 5 minutes to 20 hours 37 minutes) for referrals from general practitioners (P<0.0001). Use of emergency services reduced delays to hospital (odds ratio 0.45, 95% confidence interval 0.23 to 0.61). The median time to evaluation by a senior doctor was 1 hour 9 minutes (interquartile range 33 minutes to 1 hour 50 minutes) but was undertaken in only 477 (65%) patients within 3 hours of arrival. This was not influenced by age, sex, time of presentation, mode of referral, hospital type, or the presence of a stroke unit. Computed tomography was requested within 3 hours of arrival in 166 (22%) patients but undertaken in only 60 (8%). CONCLUSION: Delays in patients arriving at hospital with suspected stroke can be reduced by the increased use of emergency services. Over a third of patients arrive at hospital within three hours of stroke; their management can be improved by expediting medical evaluation and performing computed tomography early.
Authors: M J Alberts; G Hademenos; R E Latchaw; A Jagoda; J R Marler; M R Mayberg; R D Starke; H W Todd; K M Viste; M Girgus; T Shephard; M Emr; P Shwayder; M D Walker Journal: JAMA Date: 2000-06-21 Impact factor: 56.272
Authors: M Schilling; M Kros; M Ritter; M Ohms; W R Schäbitz; W Kusch; E B Ringelstein; T P Weber; U Harding; A Bohn Journal: Nervenarzt Date: 2012-06 Impact factor: 1.214
Authors: Innocenti Eleonora; Nencini Patrizia; Romani Ilaria; Del Bene Alessandra; Arba Francesco; Piccardi Benedetta; Pracucci Giovanni Journal: Neurol Sci Date: 2013-06-27 Impact factor: 3.307
Authors: Natalia Pérez de la Ossa; Mónica Millán; Juan F Arenillas; Josep Sánchez-Ojanguren; Ernest Palomeras; Laura Dorado; Cristina Guerrero; Antoni Dávalos Journal: J Neurol Date: 2009-04-08 Impact factor: 4.849