Abstract TP415: Stroke Knowledge and Prehospital Delay in Elderly Acute Ischemic Stroke Patients

Abstract

Background: Stroke is one of the leading causes of deaths in Korea and worldwide. Due to delayed hospital arrival after stroke onset, acute ischemic stroke (AIS) patients are unable to receive a reperfusion therapy promptly. Early recognition of stoke symptoms is crucial to reduce prehospital delay time and further stroke morbidity and mortality. With rapidly increasing aging population in Korea, the prevalence of AIS is growing. Yet, little is reported about stroke knowledge and the association with prehospital delay in elderly AIS patients in Korea. Purpose: We hypothesized that the level of stroke knowledge would be different by socioeconomic status (SES) and associated with prehospital delay among elderly AIS patients. Methods: A cross-sectional, descriptive study was conducted in a convenience sample of 188 older adults who hospitalized with AIS in Korea. Data, including stroke knowledge were collected by interview using structured questionnaires. Descriptive statistics, chi-square test, Mann-Whitney U test, and univariate and multivariate Cox regression analyses were used. Results: More than one third (36.7%) did not know any of stroke symptoms, whereas one symptom was recognized by 48.9% and 2 or more symptoms by 14.4%. Individuals who had low income (χ 2 =10.47) showed poorer knowledge than their counterparts ( p <.05). Those who arrived to the hospital within 3 hours were more likely to recognize hemiparesis (χ 2 =7.38) and headache (χ 2 =7.67) as primary symptoms at p <.01. Individuals who recognized more than 2 primary symptoms had shorter arrival time ( U =1145.5, p <.05). Multivariate Cox regression analyses revealed that knowledge on hemiparesis was associated with hospital arrival time (hazard ratio=.329, 95% confidence interval=.187-.578) at p =.000. Conclusion: While stroke symptoms were poorly recognized by most patients, none of the SES except income was significantly associated with the level of stroke knowledge. The study findings suggest that clinicians who handle elderly AIS patients should pay attention who have low income as they showed lower level of stroke knowledge. Also, continuous public education on stroke symptoms is necessary to increase the level of stroke knowledge, which will shorten hospital arrival time.