Time interval between stroke onset and hospital arrival in acute ischemic stroke patients in Shanghai, China

To observe the time interval between stroke onset and hospital arrival (time-to-hospital) in acute ischemic stroke patients and analyze its putatively associated factors.

During the period from November 1, 2006 to August 31, 2008, patients with acute ischemic stroke admitted consecutively to the Department of Neurology, Ninth Hospital, Shanghai, were enrolled in the study. Information of the patients was registered including the time-to-hospital, demographic data, history of stroke, season at attack, neurological symptom at onset, etc. Characteristics of the patients were analyzed and logistic regression analyses were conducted to identify factors associated with the time-to-hospital.

There were 536 patients in the study, 290 (54.1%) males and 246 (45.9%) females. The median time-to-hospital was 8h (ranged from 0.1 to 300 h) for all patients. Within 3h after the onset of stroke, 162 patients (30.2%) arrived at our hospital; and within 6h, 278 patients (51.9%). Patients with a history of stroke, unconsciousness at onset, or a high NIHSS score at admission had significantly less time-to-hospital.

The time interval between stroke onset and hospital arrival was <6h for around half of our patients with acute cerebral ischemic stroke. A history of stroke and severe symptoms at onset were significantly associated with shorter time-to-hospital. The results might indicate that the knowledge of stroke and understanding the importance of seeking immediate medical help after stroke onset of patients and their relatives could significantly influence their actions.