Factores asociados al tiempo de llegada de pacientes con enfermedad cerebrovascular al servicio de urgencias de un hospital peruano

Abstract

The implementation of stroke units and of thrombolysis as treatment in cerebrovascular disease (CVD) brought about a radical change in its management, but which is influenced by the time patients take to reach the health centre following the onset of symptoms. This study seeks to determine the time needed by CVD patients to reach the Emergency Department at the Hospital Nacional Guillermo Almenara Irigoyen (HNGAI) and to establish the sociocultural and cultural factors that can affect it. We carried out a prospective study of 186 patients diagnosed as suffering from CVD on urgent admission to the HNGAI. Both the time lapsed between the onset of symptoms and the sociocultural and cultural factors of the patient and the person accompanying them were determined. Patients were divided into two groups: those with a short arrival time (< 3 hours) and those who took longer (> 3 hours); statistically significant differences were found in the factors under study. The mean time taken to reach Emergency was 22 h 57 min 19 s; 22.58% had a short arrival time; the predominant socioeconomic factors were the degree of primary schooling (49.46%), being a pensioner (44.1%), living in company (94.6%) and recognition of the symptoms (36.6%); the most commonly used means of transport were taxi (47.31%) and ambulance (45.16%). The person who accompanied them had a higher (44.09%) or secondary (43.01%) education, was employed (33.3%), and recognised the symptoms (65.6%). An important number of CVD patients (22.58%) reach the Emergency Department shortly after the onset of symptoms. Recognition of the symptoms by the person accompanying the patient and taking them to hospital by taxi are linked to early arrival, which are factors that should be taken into account when implementing an stroke unit in our area.