Alejandro Gonzalez-Aquines1, Adolfo C Cordero-Pérez1, Mario Cristobal-Niño1, Gil Pérez-Vázquez1, Fernando Góngora-Rivera2. 1. Department of Neurology, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Av. Franciso Madero y Av. Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico. 2. Department of Neurology, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Av. Franciso Madero y Av. Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico. Electronic address: fernando.gongora@hotmail.com.
Abstract
BACKGROUND: Stroke is a leading cause of death and disability. Tissue plasminogen activator (tPA) improves the clinical outcome when administered properly; however, the most important factor to receive tPA is time. The main reason for late hospital arrival is a considerable delay in onset-to-alarm time (OAT), comprising more than 50% of the onset-to-door time. AIMS: To identify the factors associated with a delay in OAT and evaluate its contribution to onset-to-door time in ischemic stroke patients. METHODS: Prospective cohort of stroke patients admitted to the UANL University Hospital. OAT was defined as the time from identification of stroke symptoms to the decision to seek medical attention. RESULTS: A total of 189 patients were included. Mean age was 61 ± 13 years, 62% were men. One-hundred and one patients had a short OAT, but only 20.9% arrived during the first 3 hours after stroke onset. Being employed (P = 0032; odds ratio [OR] 2.784, 95% confidence interval [CI] 1.091-7.104), attributing symptoms to stroke (P = 0016; OR 3.348, 95% CI 1.254-8.936), and perceiving stroke symptoms as severe (P = 0031;OR 2.428, 95% CI 1.083-5.445) were associated with a shorter OAT. CONCLUSIONS: OAT consumes a considerable amount of the onset-to-door time. It is necessary to increase stroke knowledge and emphasize the severity of stroke, regardless of the severity of its clinical manifestations to reduce the prehospital delay, especially in countries with limited access to treatment with an extended time frame.
BACKGROUND:Stroke is a leading cause of death and disability. Tissue plasminogen activator (tPA) improves the clinical outcome when administered properly; however, the most important factor to receive tPA is time. The main reason for late hospital arrival is a considerable delay in onset-to-alarm time (OAT), comprising more than 50% of the onset-to-door time. AIMS: To identify the factors associated with a delay in OAT and evaluate its contribution to onset-to-door time in ischemic strokepatients. METHODS: Prospective cohort of strokepatients admitted to the UANL University Hospital. OAT was defined as the time from identification of stroke symptoms to the decision to seek medical attention. RESULTS: A total of 189 patients were included. Mean age was 61 ± 13 years, 62% were men. One-hundred and one patients had a short OAT, but only 20.9% arrived during the first 3 hours after stroke onset. Being employed (P = 0032; odds ratio [OR] 2.784, 95% confidence interval [CI] 1.091-7.104), attributing symptoms to stroke (P = 0016; OR 3.348, 95% CI 1.254-8.936), and perceiving stroke symptoms as severe (P = 0031;OR 2.428, 95% CI 1.083-5.445) were associated with a shorter OAT. CONCLUSIONS:OAT consumes a considerable amount of the onset-to-door time. It is necessary to increase stroke knowledge and emphasize the severity of stroke, regardless of the severity of its clinical manifestations to reduce the prehospital delay, especially in countries with limited access to treatment with an extended time frame.
Authors: Erwin Chiquete; Amado Jiménez-Ruiz; Miguel García-Grimshaw; Rogelio Domínguez-Moreno; Elizabeth Rodríguez-Perea; Paola Trejo-Romero; Eduardo Ruiz-Ruiz; Valeria Sandoval-Rodríguez; Juan José Gómez-Piña; Guillermo Ramírez-García; Ana Ochoa-Guzmán; Liz Toapanta-Yanchapaxi; Fernando Flores-Silva; José Luis Ruiz-Sandoval; Carlos Cantú-Brito Journal: Neurol Sci Date: 2020-11-25 Impact factor: 3.307
Authors: Giovanni Frisullo; Valerio Brunetti; Riccardo Di Iorio; Aldobrando Broccolini; Pietro Caliandro; Mauro Monforte; Roberta Morosetti; Carla Piano; Fabio Pilato; Paolo Calabresi; Giacomo Della Marca Journal: Neurol Sci Date: 2020-07-06 Impact factor: 3.307