Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study
<i>Background and objectives</i>: The time interval between stroke onset and hospital arrival is a major barrier for reperfusion therapies in acute ischemic stroke and usually accounts for most of the onset-to-treatment delay. The present study aimed to analyze the pre-hospital delays fo...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/8/1003 |
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| author | Elena Oana Terecoasă Răzvan Alexandru Radu Anca Negrilă Iulian Enache Bogdan Cășaru Cristina Tiu |
| author_facet | Elena Oana Terecoasă Răzvan Alexandru Radu Anca Negrilă Iulian Enache Bogdan Cășaru Cristina Tiu |
| author_sort | Elena Oana Terecoasă |
| collection | DOAJ |
| description | <i>Background and objectives</i>: The time interval between stroke onset and hospital arrival is a major barrier for reperfusion therapies in acute ischemic stroke and usually accounts for most of the onset-to-treatment delay. The present study aimed to analyze the pre-hospital delays for patients with acute ischemic stroke admitted to a tertiary stroke center in Romania and to identify the factors associated with a late hospital arrival. <i>Material and methods</i>: The study population consisted of 770 patients hospitalized with the diagnosis of acute ischemic stroke in the University Emergency Hospital Bucharest during a 6-month period, between 1 January and 30 June 2018. Data regarding pre-hospital delays were prospectively collected and analyzed together with the demographic and clinical characteristics of the patients. <i>Results</i>: In total, 31.6% of patients arrived at the hospital within 4.5 h from stroke onset and 4.4% in time intervals between 4.5 and 6 h from the onset, and 28.7% of the patients reached the hospital more than 24 h after onset of symptoms. Transport to hospital by own means was the only factor positively associated with arrival to hospital > 4.5 h from stroke onset and more than doubled the odds of late arrival. Factors negatively associated with hospital arrival > 4.5 h after stroke onset were prior diagnosis of atrial fibrillation, initial National Institute of Health Stroke Scale (NIHSS) score ≥ 16 points, presence of hemianopsia, facial palsy and sensory disturbance. Factors increasing the odds of hospital arrival after 24 h from stroke onset were living alone and living in rural areas. <i>Conclusions</i>: Almost one in three ischemic stroke patients presenting to our center reaches hospital more than 24 h after onset of symptoms. These findings highlight the need for urgent measures to improve not only stroke awareness but also pre-hospital protocols in order to provide timely and appropriate care for our stroke patients. |
| first_indexed | 2024-03-09T09:53:10Z |
| format | Article |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T09:53:10Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-b72781a8aff945008bce92d48ddae32e2023-12-01T23:58:22ZengMDPI AGMedicina1010-660X1648-91442022-07-01588100310.3390/medicina58081003Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional StudyElena Oana Terecoasă0Răzvan Alexandru Radu1Anca Negrilă2Iulian Enache3Bogdan Cășaru4Cristina Tiu5Department of Neurology, University Emergency Hospital Bucharest, 050098 Bucharest, RomaniaDepartment of Clinical Neurosciences, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, RomaniaDepartment of Neurology, University Emergency Hospital Bucharest, 050098 Bucharest, RomaniaDepartment of Neurology, University Emergency Hospital Bucharest, 050098 Bucharest, RomaniaDepartment of Neurology, University Emergency Hospital Bucharest, 050098 Bucharest, RomaniaDepartment of Neurology, University Emergency Hospital Bucharest, 050098 Bucharest, Romania<i>Background and objectives</i>: The time interval between stroke onset and hospital arrival is a major barrier for reperfusion therapies in acute ischemic stroke and usually accounts for most of the onset-to-treatment delay. The present study aimed to analyze the pre-hospital delays for patients with acute ischemic stroke admitted to a tertiary stroke center in Romania and to identify the factors associated with a late hospital arrival. <i>Material and methods</i>: The study population consisted of 770 patients hospitalized with the diagnosis of acute ischemic stroke in the University Emergency Hospital Bucharest during a 6-month period, between 1 January and 30 June 2018. Data regarding pre-hospital delays were prospectively collected and analyzed together with the demographic and clinical characteristics of the patients. <i>Results</i>: In total, 31.6% of patients arrived at the hospital within 4.5 h from stroke onset and 4.4% in time intervals between 4.5 and 6 h from the onset, and 28.7% of the patients reached the hospital more than 24 h after onset of symptoms. Transport to hospital by own means was the only factor positively associated with arrival to hospital > 4.5 h from stroke onset and more than doubled the odds of late arrival. Factors negatively associated with hospital arrival > 4.5 h after stroke onset were prior diagnosis of atrial fibrillation, initial National Institute of Health Stroke Scale (NIHSS) score ≥ 16 points, presence of hemianopsia, facial palsy and sensory disturbance. Factors increasing the odds of hospital arrival after 24 h from stroke onset were living alone and living in rural areas. <i>Conclusions</i>: Almost one in three ischemic stroke patients presenting to our center reaches hospital more than 24 h after onset of symptoms. These findings highlight the need for urgent measures to improve not only stroke awareness but also pre-hospital protocols in order to provide timely and appropriate care for our stroke patients.https://www.mdpi.com/1648-9144/58/8/1003pre-hospital delayonset-to-door timeischemic strokereperfusion therapyintravenous thrombolysis |
| spellingShingle | Elena Oana Terecoasă Răzvan Alexandru Radu Anca Negrilă Iulian Enache Bogdan Cășaru Cristina Tiu Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study Medicina pre-hospital delay onset-to-door time ischemic stroke reperfusion therapy intravenous thrombolysis |
| title | Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study |
| title_full | Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study |
| title_fullStr | Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study |
| title_full_unstemmed | Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study |
| title_short | Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania—A Cross-Sectional Study |
| title_sort | pre hospital delay in acute ischemic stroke care current findings and future perspectives in a tertiary stroke center from romania a cross sectional study |
| topic | pre-hospital delay onset-to-door time ischemic stroke reperfusion therapy intravenous thrombolysis |
| url | https://www.mdpi.com/1648-9144/58/8/1003 |
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