Time of hospital presentation after stroke. A multicenter study in north-east Italy

Abstract

Given the current orientation towards the early treatment of stroke, this multicenter study was carried out in North-east Italy in order to examine the times between stroke onset and hospital admission, and the possible factors leading to a lengthening of such times. An analysis was made of 348 patients, 79.8% of whom had experienced an ischemic cerebral infarct. Arrival times were not significantly modified by the distance from hospital, age, family cohabitation, socio-cultural level, population density or the geographical location of the Center. Sixty percent of the ischemic stroke cases arrived at the Emergency Department within three hours, and 80% within six hours; the hemorrhagic cases arrived earlier, 100% of them by the tenth hour. The duration of stay in the Emergency Department did not vary in relation to the severity or type of stroke. Greater severity, a reduced level of awareness and daytime onset led to a moderately significant reduction on presentation times. In conclusion, the majority of patients arrived sufficiently quickly to be treated within the "therapeutic window"; nevertheless, an information campaign may be useful in accelerating the hospital presentation of the albeit limited number of cases who arrive late.