BACKGROUND: Early management improves outcome in acute stroke. This study was designed to assess the prehospital path from symptom onset to arrival in hospital and to identify factors associated with prehospital delay. METHODS: A prospective study was conducted including patients with acute ischaemic stroke, intracerebral haemorrhage and transient ischaemic attack admitted to hospital. Time intervals for prehospital delay, background data, severity, type of first medical contact and mode of transport were recorded. Univariate and multivariate analyses were performed to identify factors influencing prehospital delay. RESULTS: A total of 440 patients were included, with a mean age of 71.4±13.0 years (44.3% female subjects), consisting of 65.9% patients with ischaemic stroke, 11.4% with intracerebral haemorrhage and 22.7% with transient ischaemic attack. The median time from symptom onset to admission was 3.0 h (179 min; IQR 77-542). The median decision delay was 1.5 h (92 min, IQR 25-405) and accounted for 55.1% (median value) of the prehospital delay. 310 (70.5%) patients arrived by ambulance. In the multivariate linear regression analysis, high National Institute of Health Stroke Scale score (p<0.001), transport by ambulance (p<0.001) and lower age (p=0.048) were significantly associated with early admission. CONCLUSIONS: Severe strokes, use of ambulance and lower age are associated with reduced prehospital delay. The present study shows that more than half of the delay is caused by the hesitation to contact medical services. Public information campaigns should focus on fast symptom recognition and the importance of immediately contacting the Emergency Medical Services upon symptom onset.
BACKGROUND: Early management improves outcome in acute stroke. This study was designed to assess the prehospital path from symptom onset to arrival in hospital and to identify factors associated with prehospital delay. METHODS: A prospective study was conducted including patients with acute ischaemic stroke, intracerebral haemorrhage and transient ischaemic attack admitted to hospital. Time intervals for prehospital delay, background data, severity, type of first medical contact and mode of transport were recorded. Univariate and multivariate analyses were performed to identify factors influencing prehospital delay. RESULTS: A total of 440 patients were included, with a mean age of 71.4±13.0 years (44.3% female subjects), consisting of 65.9% patients with ischaemic stroke, 11.4% with intracerebral haemorrhage and 22.7% with transient ischaemic attack. The median time from symptom onset to admission was 3.0 h (179 min; IQR 77-542). The median decision delay was 1.5 h (92 min, IQR 25-405) and accounted for 55.1% (median value) of the prehospital delay. 310 (70.5%) patients arrived by ambulance. In the multivariate linear regression analysis, high National Institute of Health Stroke Scale score (p<0.001), transport by ambulance (p<0.001) and lower age (p=0.048) were significantly associated with early admission. CONCLUSIONS: Severe strokes, use of ambulance and lower age are associated with reduced prehospital delay. The present study shows that more than half of the delay is caused by the hesitation to contact medical services. Public information campaigns should focus on fast symptom recognition and the importance of immediately contacting the Emergency Medical Services upon symptom onset.
Authors: Andrea Tampieri; Eugenio Giovannini; Anna Maria Rusconi; Lorenzo Cristoni; Daniela Bendanti; Patrizia Cenni; Tiziano Lenzi Journal: Intern Emerg Med Date: 2014-11-28 Impact factor: 3.397
Authors: Michael J Lyerly; Karen C Albright; Amelia K Boehme; Reza Bavarsad Shahripour; James T Houston; Pawan V Rawal; Niren Kapoor; Muhammad Alvi; April Sisson; Anne W Alexandrov; Andrei V Alexandrov Journal: J Neurol Disord Stroke Date: 2013-09-13
Authors: Laura Heitsch; Laura Ibanez; Caty Carrera; Michael M Binkley; Daniel Strbian; Turgut Tatlisumak; Alejandro Bustamante; Marc Ribó; Carlos Molina; Antoni Dávalos; Elena López-Cancio; Lucia Muñoz-Narbona; Carol Soriano-Tárraga; Eva Giralt-Steinhauer; Victor Obach; Agnieszka Slowik; Joanna Pera; Katarzyna Lapicka-Bodzioch; Justyna Derbisz; Tomás Sobrino; José Castillo; Francisco Campos; Emilio Rodríguez-Castro; Susana Arias-Rivas; Tomas Segura; Gemma Serrano-Heras; Cristófol Vives-Bauza; Rosa Díaz-Navarro; Silva Tur; Carmen Jimenez; Joan Martí-Fàbregas; Raquel Delgado-Mederos; Juan Arenillas; Jerzy Krupinski; Natalia Cullell; Nuria P Torres-Aguila; Elena Muiño; Jara Cárcel-Márquez; Francisco Moniche; Juan A Cabezas; Andria L Ford; Rajat Dhar; Jaume Roquer; Pooja Khatri; Jordi Jiménez-Conde; Israel Fernandez-Cadenas; Joan Montaner; Jonathan Rosand; Carlos Cruchaga; Jin-Moo Lee Journal: Stroke Date: 2020-12-15 Impact factor: 7.914