Factors delaying hospital arrival of patients with acute stroke

J Pak Med Assoc. 2008 Apr;58(4):178-82.

Abstract

Introduction: To determine the proportion of patients with acute stroke presenting late to hospital and to identify the factors that delay hospital arrival of patients with acute stroke.

Methods: A cross sectional study was carried out between Sept 2006 to Feb 2007 in the department of Neurology, Liaquat National Hospital Karachi. All patients of both genders, ago >18 years with symptoms of stroke and neuro- imaging (CT scan/MRI brain) findings consistent with stroke were included.

Results: Atotal of 165 patients attending the Emergency department were included. There were 86 (52%) males and 79 (47.9%) females. The mean age was 60.04+/-13.98 years, (males 58.2 years and females 61.9 years). The median delay from onset of symptoms to hospital arrival was six hours. Only 28.5% of the patients came within three hours while 71.5% after three hours. Attendants of 47 patients had a low throat perception, 53 (32%) of the patients did not know a single symptom of stroke and 63% (104) patients first contacted their General Practitioner who referred them to hospital. Similarly 60.6% of patients wore first taken to a local hospital not equipped to handle major emergencies.

Conclusion: Time elapsed from onset of symptoms to hospital arrival is influenced by lack of knowledge of stroke symptoms, contact with a local doctor, low threat perception and non availability of ambulance services.

MeSH terms

  • Acute Disease
  • Ambulatory Care / organization & administration
  • Ambulatory Care / statistics & numerical data*
  • Cross-Sectional Studies
  • Emergency Medical Services / supply & distribution*
  • Female
  • Hospitalization*
  • Humans
  • Male
  • Middle Aged
  • Pakistan
  • Stroke / therapy*
  • Time Factors