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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Prehospital delay in acute stroke and TIA
Kashif Waqar Faiz1, Antje Sundseth, Bente Thommessen
1Institute of Clinical Medicine, University of Oslo, Oslo, Norway. kashif.faiz@medisin.uio.no
Emergency Medicine Journal : EMJ
|August 14, 2012
Summary
Reducing prehospital delay in stroke patients is crucial for better outcomes. Severe strokes, ambulance use, and younger age are linked to faster hospital arrival, but patient hesitation to seek care is a major factor.
Area of Science:
- Neurology
- Emergency Medicine
- Public Health
Background:
- Timely management significantly improves outcomes in acute stroke cases.
- Understanding prehospital pathways and delays is essential for optimizing stroke care.
- This study investigates the journey from symptom onset to hospital arrival for acute stroke patients.
Purpose of the Study:
- To assess the prehospital pathway for patients experiencing acute stroke symptoms.
- To identify key factors contributing to prehospital delay in stroke patients.
- To inform strategies for reducing delays in emergency stroke treatment.
Main Methods:
- Prospective study including patients with ischemic stroke, intracerebral hemorrhage, and transient ischemic attack.
- Recorded time intervals for prehospital delay, patient demographics, stroke severity, and mode of transport.
- Utilized univariate and multivariate analyses to determine factors influencing prehospital delay.
Main Results:
- A total of 440 patients were analyzed (mean age 71.4 years; 44.3% female).
- Median time from symptom onset to admission was 3.0 hours, with decision delay accounting for over half.
- High National Institutes of Health Stroke Scale score, ambulance transport, and younger age were associated with earlier admission.
Conclusions:
- Severe strokes, ambulance use, and younger age correlate with reduced prehospital delay.
- Hesitation to contact medical services is a primary driver of prehospital delay, exceeding 50%.
- Public awareness campaigns should emphasize rapid symptom recognition and immediate Emergency Medical Services activation.
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