Abstract TP338: Knowledge of Stroke Core Symptoms Are Important for Help-seeking Behavior and Receiving Reperfusion Therapy

Abstract

Introduction: We investigated the association between pre-stroke core symptom knowledge and recognition of core symptoms at stroke onset, with prehospital delay and receiving reperfusion therapies. Core symptoms are defined as facial palsy, palsy of extremities and aphasia/dysarthria. Methods: A cross-sectional study of consecutive patients with acute stroke and TIA admitted at two stroke centres in the Central Denmark Region, between January 28 th 2018 and May 10 th 2018. Structured interviews of patients and bystanders (separately), combined with clinical information from the Danish stroke registry were obtained. Eligible patient were > 18 years, independent in daily activities (mRS<3) with stroke onset-to-interview ≤7 days. Results: We included 469 of 1210 stroke/TIA patients in the period with a median (IQR) age of 71 (61-80). Median (IQR) admission-to-interview time was 1 (1-1) day. Pre-stroke knowledge of ≥ 1 core symptom was 46 % for patients and 71 % for bystanders. Knowledge of ≥ 2 core symptoms was 22 % and 52 % respectively. Pre-stroke knowledge in patients was not significantly associated to EMS contact, onset-to admission < 3 hours or reperfusions therapy, but in bystanders pre-stroke knowledge of ≥ 2 core symptoms was associated with increased EMS contact OR (95% CI) 2,35 (1,24-4.45) and receiving reperfusion therapy 1,94 (1,04-3.61). Help-seeking based on ≥ 1 observed core symptom at onset by bystanders and ≥ 2 core symptoms experienced by patients were significantly associated with a direct EMS contact, onset-to admission < 3 hours and receiving reperfusions therapy. Conclusions: Pre-stroke knowledge and help-seeking based on observed core symptoms at onset is essential reducing prehospital delay and increasing reperfusion rates. The pivotal role of bystanders “to act” should be a target for future stroke awareness campaigns.