Stroke awareness and factors influencing hospital arrival time: a prospective observational study

Data concerning stroke awareness and factors associated with time of hospital arrival for acute stroke patients in Thailand are still lacking.

To assess stroke awareness and to identify factors influencing hospital arrival time after an acute stroke.

This is aprospective study comprising consecutive acute stroke patients admitted in Siriraj Hospital, Bangkok, Thailand between August 2010 and December 2011. Demographic data, stroke severity using the NIHSS, diagnosis and stroke awareness questionnaire were collected.

Of 217 acute stroke patients, mean age was 66 ± 13.7 years. Mean stroke severity was 10 ± 7.6. Patients arrived at the Emergency Department within 4.5 hours (early hospital arrival: EHA) in 38.2% of the cases, 16.6% by ambulance. Only 34.6% of patients recognized that they were having stroke. Factors associated with EHA were 1) stroke awareness (OR 1.96, 95% CI 1.07-3.60, p = 0.030), 2) arrival by ambulance (OR 2.23, 95% CI 1.03-4.81, p = 0.042), and 3) NIHSS >15 (OR 2.26, 95% CI 1.17-4.35, p = 0.015).

Only one-third of patients were aware of stroke symptoms. Only one in six patients used emergency transportation. Public educational campaign is needed to increase the community awareness of stroke warning symptoms and the urgent emergency medical services.