Prehospital delay and its influencing factors in acute ischemic stroke in Fuxin area

Abstract

Objective To investigate Prehospital delay and its influencing factors in acute ischemic stroke in Fuxin area. Methods Consecutive patients with acute ischemic stroke admitted from March 1, 2015 to July 1, 2017 were enrolled prospectively. The patients were grouped by the cutoff value from onset to admission time ≤3 h. The demographic data, vascular risk factors, onset to admission time, and clinical data were recorded. Multivariate logistic regression analysis was used to identify the independent influencing factors of prehospital delay. Results A total of 758 patients were enrolled, including 123 (16.2%) from the onset to the admission time ≤3 h. Multivariate logistic regression analysis showed that women (odds ratio, [OR] 14.782, 95% confidence interval [CI] 2.378-91.809; P=0.004), Mongolian (OR 6.218, 95% CI 1.642-23.520; P=0.008), low level of education (0-6 years: OR 5.047, 95% CI 1.306-19.519; P=0.023), place of residence (suburb or rural area: OR 4.024, 95% CI 1.080-14.987; P=0.038), low economic income (0-1500 yuan/month: OR 5.985, 95% CI 1.500-23.873; P=0.011), previous history of stroke/transient ischemic attack (OR 6.293, 95% CI 1.558-25.384; P=0.013), National Institutes of Health Stroke Scale score ≤8 (OR 12.352, 95% CI 3.239-47.119; P<0.001), limb weakness (OR 3.335, 95% CI 1.043-10.658; P=0.042) and dizziness (OR 7.031, 95% CI 1.814-14.027; P=0.005) as the initial symptom, transportation means (non-120 ambulances, private cars or taxis: OR 1.929, 95%CI 1.106-3.366; P=0.021), transferred from other hospital (OR 1.761, 95% CI 1.011-3.067; P=0.045), and first visit hospitals as health centers or primary hospitals (OR 1.811, 95% CI 1.034-3.173; P=0.037) were the independent factors of prehospital delay in patients with acute ischemic stroke. Conclusion Women, Mongolian, educational level, residence, economic income, history of stroke/transient ischemic attack, severity of illness, transportation initial, level of first visit hospital, and transfered from other hospital are the influencing factors for prehospital delay in patients with acute ischemic stroke in Fuxin area. Key words: Stroke; Brain Ischemia; Hospitalization; Transportation of Patients; Time Factors