Yafang Zhu1, Xia Zhang2, Shoujiang You3, Xiaowei Cao4, Xuan Wang5, Wenjie Gong6, Yan Qin7, Xiaojun Huang8, Yongjun Cao9, Rongfang Shi10. 1. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: 1003758150@qq.com. 2. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: stefence1025@163.com. 3. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: 0319503013@163.com. 4. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: 516924304@qq.com. 5. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: 240365170@qq.com. 6. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: gongwenjie0220@126.com. 7. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: 260008274@qq.com. 8. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: 495642655@qq.com. 9. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: yongjuncao@126.com. 10. Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China. Electronic address: rf.sh@163.com.
Abstract
BACKGROUND: Pre-hospital delay was a critical factor affecting stroke patients receiving intravenous thrombolytic therapy. The aim of this study was to explore the factors associated with pre-hospital delay and thrombolysis in China. METHODS: Patient data were obtained from emergency department (ED), and the factors of patient pre-hospital delay were recorded through a well-designed form. RESULTS: A total of 630 patients were eventually included in the study. 317 patients were admitted to the ED during the thrombolysis time window, and only 105 patients received intravenous thrombolytic therapy. In the univariate analysis, transportation (OR: 0.15; 95% CI: 0.44 - 0.518; p = 0.001), atrial fibrillation (OR: 0.555; 95% CI: 0.372-0.828; p = 0.004) and response of symptoms (OR: 0.002; 95% CI: 0.000-0.013; p = 0.000) were associated with early arrival. Speech disturbances (OR: 2.095; 95% CI: 1.294-3.391; p = 0.002), smoking (OR: 2.563; 95% CI: 1.527-4.304; p = 0.000), alcohol consumption (OR: 2.155; 95% CI: 1.159-4.005; p = 0.014) and referral presentation (OR: 2.837; 95% CI: 1.584-5.082; p = 0.000) were associated with thrombolysis. In the logistic regression analysis, direct visiting to the hospital after onset and rushing to emergency after onset were independent predictor of early arrival of AIS and intravenous thrombolytic. CONCLUSIONS: The pre-hospital delay of acute ischemic stroke in China was still serious. Strengthening the ability to identify stroke-related symptoms and establishing a mutual referral medical support service model between lower and upper hospitals may effectively shorten the pre-hospital delay of stroke patients.
BACKGROUND: Pre-hospital delay was a critical factor affecting strokepatients receiving intravenous thrombolytic therapy. The aim of this study was to explore the factors associated with pre-hospital delay and thrombolysis in China. METHODS:Patient data were obtained from emergency department (ED), and the factors of patient pre-hospital delay were recorded through a well-designed form. RESULTS: A total of 630 patients were eventually included in the study. 317 patients were admitted to the ED during the thrombolysis time window, and only 105 patients received intravenous thrombolytic therapy. In the univariate analysis, transportation (OR: 0.15; 95% CI: 0.44 - 0.518; p = 0.001), atrial fibrillation (OR: 0.555; 95% CI: 0.372-0.828; p = 0.004) and response of symptoms (OR: 0.002; 95% CI: 0.000-0.013; p = 0.000) were associated with early arrival. Speech disturbances (OR: 2.095; 95% CI: 1.294-3.391; p = 0.002), smoking (OR: 2.563; 95% CI: 1.527-4.304; p = 0.000), alcohol consumption (OR: 2.155; 95% CI: 1.159-4.005; p = 0.014) and referral presentation (OR: 2.837; 95% CI: 1.584-5.082; p = 0.000) were associated with thrombolysis. In the logistic regression analysis, direct visiting to the hospital after onset and rushing to emergency after onset were independent predictor of early arrival of AIS and intravenous thrombolytic. CONCLUSIONS: The pre-hospital delay of acute ischemic stroke in China was still serious. Strengthening the ability to identify stroke-related symptoms and establishing a mutual referral medical support service model between lower and upper hospitals may effectively shorten the pre-hospital delay of strokepatients.
Authors: Syaribah Noor Brice; Justin J Boutilier; Daniel Gartner; Paul Harper; Vincent Knight; Jen Lloyd; Aryono Djuned Pusponegoro; Asti Puspita Rini; Jonathan Turnbull-Ross; Mark Tuson Journal: BMC Health Serv Res Date: 2022-05-13 Impact factor: 2.908