Abstract
Objective: It is known that intravenous thrombolytic therapy in ischemic stroke is beneficial in selected patients who arrived within the first 4.5 hours after the onset of the symptoms and the effectiveness of the treatment depends on early arrival to the hospital. The more patients arrival to the hospital within this time zone, the more they will have the chance to receive thrombolytic therapy. This study aims to investigate the factors that cause delay in the arrival of patients with ischemic stroke to the hospital. Methods: Patients diagnosed with acute ischemic stroke who applied to the neurology outpatient clinic and emergency room between February and May 2019 were included in the study. A direct interview survey was conducted to investigate the factors that delay the arrival to patients or relatives of the patients arrival to Bursa Yuksek Ihtisas Training and Research Hospital due to acute stroke. According to the time of arrival to the hospital after the onset of stroke symptoms, patients were classified as early ( 4.5 hours) and late arrival (> 4.5 hours). Based on this grouping, factors causing delay in patients' access to hospital were compared statistically. Results: A total of 251 patients and / or patient relatives who arrived to the emergency and neurology outpatient clinic were interviewed. Of the 251 patients included in the study, 119 (47.4%) were female and the mean age was 70 (34-94) years. Approximately 72.5% of the patients were arrived in the first 4.5-hour slice after the onset of stroke symptoms. Factors causing late arrival were determined as being female, having low NIHSS score and not using ambulance in transportation. Conclusion: Due to the delay in arrival of 27.5% of the patients, there is no chance to apply thrombolytic therapy to eligible ones. The factors resulting in the delay were discovered as female gender, low severity of the stroke and transportation without ambulance. In this respect, community-oriented trainings are required.
Highlights
Stroke is one of the leading causes of death and disability worldwide
The factors resulting in the delay were discovered as female gender, low severity of the stroke and transportation without ambulance
It is known that intravenous (IV) administration of thrombolytic therapy is helpful in selected patients in the first 4.5 hours following the onset of the symptoms and the earlier the treatment is started, the more effective it is
Summary
Stroke is one of the leading causes of death and disability worldwide. It is known that intravenous (IV) administration of thrombolytic therapy is helpful in selected patients in the first 4.5 hours following the onset of the symptoms and the earlier the treatment is started, the more effective it is. The delay from the onset of stroke to arrival at the hospital reduces the rate of these patients to be treated with thrombolytic and/or mechanical thrombectomy. For this reason, the effect of a variety of factors in the arrival time to hospital of stroke patients were examined in previous studies. The effect of a variety of factors in the arrival time to hospital of stroke patients were examined in previous studies These factors include living alone, stroke onset time, age, gender, education level, place of arrival at the hospital, income level, distance to the hospital, stroke symptoms, stroke risk factors, level of consciousness, way to reach the hospital, National Health Stroke Scale (NIHSS), contact with the local doctor, recognition of stroke symptoms by healthcare professionals, patients and the relatives.
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