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[Latent period before hospital admission in cerebrovascular pathology: determining factors]
1Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona.
Insights
Delayed hospital admission for cerebrovascular disorders is linked to smoking and specific symptoms like altered consciousness or motor deficits. Prompt admission is associated with more severe conditions and complications.
Area of Science:
- Neurology
- Public Health
- Emergency Medicine
Background:
- Timely hospital admission is critical for managing cerebrovascular disorders.
- Understanding factors influencing pre-hospital delay is essential for improving patient outcomes.
Purpose of the Study:
- To identify key factors influencing the time from symptom onset to hospital admission in patients with cerebrovascular disorders.
- To differentiate characteristics of patients with early versus delayed hospital presentation.
Main Methods:
- A cohort of 100 patients with cerebrovascular disorders was analyzed.
- Data collected included demographics, vascular risk factors, symptom presentation, and clinical course.
- Patients were categorized based on a pre-hospital latent period of ≤6 hours versus >6 hours.
Main Results:
- Delayed admission (>6 hours) was associated with smoking and a staged clinical course.
- Early admission (≤6 hours) was linked to altered consciousness, motor disorders, a stable course, and systemic complications.
- Patients admitted earlier experienced longer hospital stays.
Conclusions:
- Smoking, altered consciousness, and motor deficits are significant factors influencing delayed hospital admission for cerebrovascular disorders.
- The initial clinical presentation and course of symptoms play a crucial role in pre-hospital delay.
- Targeted interventions addressing these factors may reduce delays and improve acute stroke management.
Objective:
Establish the factors determining the latent period before hospital admission of patients with cerebrovascular disorders.
Material And Method:
One hundred patients with cerebrovascular disorders admitted to the Hospital de la Santa Creu i Sant Pau, Barcelona were analyzed. All patients were systematically interviewed, evaluating: age, sex, place of residence, initial condition, type of transport to hospital, vascular risk factors, past history of cerebrovascular disorders, time of onset of symptoms, sleeping-wakefulness state, initial symptom, accompanying symptoms, initial course of illness, complications whilst in hospital, clinical condition and functional ability on leaving hospital, and duration of stay in hospital. All these factors were compared according to the latent period before admission (6 hours or less, or more than 6 hours).
Results:
Patients with a latent period before admission of 6 hours or less more frequently had: changes in the level of consciousness (p = 0.04), motor disorders (p < 0.01), stable course (p = 0.04), systemic complications (p = 0.02) and were severely affected (p > 0.01). Patients with a latent period of more than 6 hours before admission more frequently: were smokers (p > 0.01), had a clinical course in stages (p < 0.01) and no limitation (p = 0.02). The stay in hospital lasted longer in the first group of patients. No differences were found when comparing: age, sex, place of residence, state at onset, type of transport to the hospital, vascular risk factors apart from smoking, past history of cerebrovascular illness, time of onset of symptoms, state of sleeping-wakefulness, initial symptoms and accompanying symptoms apart from changes in level of consciousness and motor defect.
Conclusions:
Factors determining delay in the hospital admission of patients with cerebrovascular disorders are: smoking, the clinical picture (alteration of consciousness, motor disorders) and the initial course of symptoms.