Cargando…

Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke

Background: Despite recent advances in acute stroke care, only 1–8% of patients can receive reperfusion therapies, mainly because of prehospital delay (PHD). Objective: This study aimed to identify factors associated with PHD from the onset of acute stroke symptoms until arrival at the hospital. Met...

Descripción completa

Detalles Bibliográficos
Autores principales: Soto-Cámara, Raúl, González-Santos, Josefa, González-Bernal, Jerónimo, Martín-Santidrian, Asunción, Cubo, Esther, Trejo-Gabriel-Galán, José M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832968/
https://www.ncbi.nlm.nih.gov/pubmed/31627368
http://dx.doi.org/10.3390/jcm8101712
_version_ 1783466268457697280
author Soto-Cámara, Raúl
González-Santos, Josefa
González-Bernal, Jerónimo
Martín-Santidrian, Asunción
Cubo, Esther
Trejo-Gabriel-Galán, José M
author_facet Soto-Cámara, Raúl
González-Santos, Josefa
González-Bernal, Jerónimo
Martín-Santidrian, Asunción
Cubo, Esther
Trejo-Gabriel-Galán, José M
author_sort Soto-Cámara, Raúl
collection PubMed
description Background: Despite recent advances in acute stroke care, only 1–8% of patients can receive reperfusion therapies, mainly because of prehospital delay (PHD). Objective: This study aimed to identify factors associated with PHD from the onset of acute stroke symptoms until arrival at the hospital. Methods: A cross-sectional study was conducted including all patients consecutively admitted with stroke symptoms to Burgos University Hospital (Burgos, Spain). Socio-demographic, clinical, behavioral, cognitive, and contextualized characteristics were recorded, and their possible associations with PHD were studied using univariate and multivariable regression analyses. Results: The median PHD of 322 patients was 138.50 min. The following factors decreased the PHD and time until reperfusion treatment where applicable: asking for help immediately after the onset of symptoms (OR 10.36; 95% confidence interval (CI) 4.47–23.99), onset of stroke during the daytime (OR 7.73; 95% CI 3.09–19.34) and the weekend (OR 2.64; 95% CI 1.19–5.85), occurrence of stroke outside the home (OR 7.09; 95% CI 1.97–25.55), using a prenotification system (OR 6.46; 95% CI 1.71–8.39), patient’s perception of being unable to control symptoms without assistance (OR 5.14; 95% CI 2.60–10.16), previous knowledge of stroke as a medical emergency (OR 3.20; 95% CI 1.38–7.40), call to emergency medical services as the first medical contact (OR 2.77; 95% CI 1.32–5.88), speech/language difficulties experienced by the patient (OR 2.21; 95% CI 1.16–4.36), and the identification of stroke symptoms by the patient (OR 1.98; 95% CI 1.03–3.82). Conclusions: The interval between the onset of symptoms and arrival at the hospital depends on certain contextual, cognitive, and behavioral factors, all of which should be considered when planning future public awareness campaigns.
format Online
Article
Text
id pubmed-6832968
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-68329682019-11-25 Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke Soto-Cámara, Raúl González-Santos, Josefa González-Bernal, Jerónimo Martín-Santidrian, Asunción Cubo, Esther Trejo-Gabriel-Galán, José M J Clin Med Article Background: Despite recent advances in acute stroke care, only 1–8% of patients can receive reperfusion therapies, mainly because of prehospital delay (PHD). Objective: This study aimed to identify factors associated with PHD from the onset of acute stroke symptoms until arrival at the hospital. Methods: A cross-sectional study was conducted including all patients consecutively admitted with stroke symptoms to Burgos University Hospital (Burgos, Spain). Socio-demographic, clinical, behavioral, cognitive, and contextualized characteristics were recorded, and their possible associations with PHD were studied using univariate and multivariable regression analyses. Results: The median PHD of 322 patients was 138.50 min. The following factors decreased the PHD and time until reperfusion treatment where applicable: asking for help immediately after the onset of symptoms (OR 10.36; 95% confidence interval (CI) 4.47–23.99), onset of stroke during the daytime (OR 7.73; 95% CI 3.09–19.34) and the weekend (OR 2.64; 95% CI 1.19–5.85), occurrence of stroke outside the home (OR 7.09; 95% CI 1.97–25.55), using a prenotification system (OR 6.46; 95% CI 1.71–8.39), patient’s perception of being unable to control symptoms without assistance (OR 5.14; 95% CI 2.60–10.16), previous knowledge of stroke as a medical emergency (OR 3.20; 95% CI 1.38–7.40), call to emergency medical services as the first medical contact (OR 2.77; 95% CI 1.32–5.88), speech/language difficulties experienced by the patient (OR 2.21; 95% CI 1.16–4.36), and the identification of stroke symptoms by the patient (OR 1.98; 95% CI 1.03–3.82). Conclusions: The interval between the onset of symptoms and arrival at the hospital depends on certain contextual, cognitive, and behavioral factors, all of which should be considered when planning future public awareness campaigns. MDPI 2019-10-17 /pmc/articles/PMC6832968/ /pubmed/31627368 http://dx.doi.org/10.3390/jcm8101712 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Soto-Cámara, Raúl
González-Santos, Josefa
González-Bernal, Jerónimo
Martín-Santidrian, Asunción
Cubo, Esther
Trejo-Gabriel-Galán, José M
Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
title Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
title_full Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
title_fullStr Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
title_full_unstemmed Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
title_short Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
title_sort factors associated with shortening of prehospital delay among patients with acute ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832968/
https://www.ncbi.nlm.nih.gov/pubmed/31627368
http://dx.doi.org/10.3390/jcm8101712
work_keys_str_mv AT sotocamararaul factorsassociatedwithshorteningofprehospitaldelayamongpatientswithacuteischemicstroke
AT gonzalezsantosjosefa factorsassociatedwithshorteningofprehospitaldelayamongpatientswithacuteischemicstroke
AT gonzalezbernaljeronimo factorsassociatedwithshorteningofprehospitaldelayamongpatientswithacuteischemicstroke
AT martinsantidrianasuncion factorsassociatedwithshorteningofprehospitaldelayamongpatientswithacuteischemicstroke
AT cuboesther factorsassociatedwithshorteningofprehospitaldelayamongpatientswithacuteischemicstroke
AT trejogabrielgalanjosem factorsassociatedwithshorteningofprehospitaldelayamongpatientswithacuteischemicstroke