Geffner Daniel, Soriano Cristina, Pérez Teresa, Vilar Carlos, Rodríguez David
Hospital General Castellon, Neurology, Avenida Benicassim s n, Castellon, Spain.
Clin Neurol Neurosurg. 2012 Jan;114(1):21-5. doi: 10.1016/j.clineuro.2011.08.014. Epub 2011 Sep 23.
To find out about stroke patients: who decides to seek medical help, where they go, how long it takes to contact the health system and to arrive at the ED.
Prospective study of patients admitted in our hospital for transient or established stroke.
Among 388 stroke patients (mean NIHSS of 7.8 (±7.4), there were 37 intracerebral hemorrhage, 70 TIA, and 281 cerebral infarction. 39.2% arrived at the ED in less than 3h. The decision to seek medical help was taken by patients in 20.4% of the episodes. First contact was with primary care in 48.3% of the cases and with Emergency Medical Services in 18.2%. The median time of decision was 60min [P25:15; P75:323]. Considering the event as serious, recognizing the stroke, not going to a primary care physician, having a TIA and onset away from home significantly decreased delay. Age, sex and previous stroke were not associated with less delay in decision nor with an earlier arrival to the ED.
In order to improve stroke treatment it is necessary to harness the use of the 112 emergency line and include primary care in the stroke assistance chain.
了解中风患者情况：谁决定寻求医疗帮助、他们前往何处、联系医疗系统以及抵达急诊科需要多长时间。
对我院收治的短暂性或确诊中风患者进行前瞻性研究。
在388例中风患者中（美国国立卫生研究院卒中量表平均分为7.8（±7.4）），有37例脑出血、70例短暂性脑缺血发作和281例脑梗死。39.2%的患者在3小时内抵达急诊科。20.4%的病例中患者自行决定寻求医疗帮助。48.3%的病例首次联系的是基层医疗服务，18.2%的病例是联系紧急医疗服务。决定就医的中位时间为60分钟[第25百分位数：15；第75百分位数：323]。将事件视为严重情况、识别出中风、未前往基层医疗医生处就诊、患有短暂性脑缺血发作以及发病地点不在家中，均显著减少了延迟时间。年龄、性别和既往中风史与缩短决定就医的延迟时间以及更早抵达急诊科均无关联。
为改善中风治疗，有必要利用112急救热线，并将基层医疗纳入中风救助链。
