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Updated: Nov 16, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
[Arrival times of patients with stroke to a public hospital]
Álvaro Soto V1, Gladys Morales I2, Gonzalo Echeverría V3
1Departamento de Especialidades Médicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
Insights
Most stroke patients arrive late to the emergency room (ER), missing critical reperfusion therapy windows. Severe strokes and proximity to the hospital are key factors for earlier emergency room consultations.
Area of Science:
- Neurology
- Emergency Medicine
- Public Health
Background:
- Stroke is a time-sensitive medical emergency requiring prompt treatment.
- Many acute ischemic stroke patients miss reperfusion therapy eligibility due to delayed hospital arrival.
Purpose of the Study:
- To determine patient arrival times at a public hospital's emergency room for stroke cases.
- To identify factors influencing timely emergency room consultation for stroke patients.
Main Methods:
- Analysis of 583 stroke patients (mean age 71 years, 55% male) presenting to an emergency room.
- Evaluation of symptom onset to emergency room arrival delay, demographics, and stroke etiology.
Main Results:
- Ischemic stroke accounted for 76% of diagnoses; median arrival time was 8 hours 11 minutes.
- Only 19% of ischemic stroke patients arrived within 3 hours, and 38% within 6 hours.
- Living near the hospital and stroke severity were significantly associated with earlier emergency room consultation (OR 5.97).
Conclusions:
- Significant delays in stroke patient arrival to the emergency room were observed.
- A small percentage of ischemic stroke patients presented within the therapeutic window for reperfusion.
- Stroke severity and geographic proximity to the hospital are critical factors for timely emergency care.
Background:
Stroke is a time-dependent emergency. Most patients with acute ischemic stroke are excluded from reperfusion therapies due to late consultation.
Aims:
To estimate the arrival times of patients with stroke to the Emergency Room (ER) of a public hospital. To identify factors associated with early consultation.
Material And Methods:
A convenience sample, 583 patients aged 71 ± 13 years (55% males) consulting for stroke at an emergency room was analyzed in terms of delay between onset of symptoms and arrival to the ER, demographics and etiology of stroke.
Results:
The admission diagnoses were ischemic stroke in 76%, intracerebral hemorrhage in 12%, transient ischemic attack in 9% and subarachnoid hemorrhage in 3%. The median time of arrival was 8 hours and 11 minutes after the onset of symptoms. Nineteen percent of consultations for ischemic stroke occurred within 3 hours of symptom onset, and 38% within 6 hours. In the logistic regression analysis, having an address near the hospital and the severity of stroke were associated with early consultation with a combined odds ratio of 5.97 (95% confidence intervals 3.23-11.04).
Conclusions:
There were significant differences in the arrival times of patients with stroke. Only a low proportion of patients with ischemic stroke consulted within the window for reperfusion therapies. Severe strokes and living near the hospital were associated with early consultation.
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