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Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched
Biniyam Tedla Mamo1, Dawit Bekele Tefera2, Makida Girma Altaye3
1Ohio State Global One Health Initiative, LLC, Addis Ababa, Ethiopia. binitm00@gmail.com.
Background:
Timely detection and early medical interventions are critical in reducing complications and mortality related to stroke. The duration from onset to hospital presentation is an essential factor in determining the outcome of stroke treatment. The sooner a stroke patient receives medical attention, the better the chances of preventing long-term complications. Pre-hospitalization delays can significantly decrease the chances of successful therapy and recovery from stroke.
Objective:
The study aims to assess predictors of delayed hospital presentation after a stroke attack.
Method:
An unmatched case-control study was conducted from September 2021 to November 2023 at Yekatit 12 Hospital Medical College. Descriptive statistics were used to describe study variables. Bivariable and multivariable logistic regression were used to identify the predictors of delay hospital presentation after stroke attack. All statistical tests were run with a significance threshold of 5%.
Result:
A total of 83 cases (presenting after four hours) and 166 controls (presenting within four or fewer hours) of an acute stroke patients were included in this study. The median duration of symptoms from the onset of stroke to hospital arrival were 24 h (IQR, 12 h) and 2 h(IQR,1 h) for cases and controls respectively. The study found that age 60 or less (AOR 1.75, 95% CI 1-3.09, p < 0.05), living outside of Addis Ababa (AOR 3.55, 95% CI 1.33-9.46, p < 0.011), onset of stroke happening at night (AOR 1.75, 95% CI 1.2-3.1, p < 0.05) and not having health insurance (AOR 0.43, 95% CI 0.23-0.8,p < 0.007) were identified as predicting factors of late presentation to hospital in stroke patients.
Conclusion:
This study highlights key predictors of delayed hospital presentation in stroke patients. Specifically, age, place of residence, health insurance, and stroke onset time were significantly influence the timeliness of seeking medical care. Recognizing and addressing the predicting factors can improve the health care treatment outcome and help to design targeted health policies that reduce barriers to timely presentation of stroke patients.
