Alberts M J, Bertels C, Dawson D V
Division of Neurology, Duke University Medical Center, Durham, NC 27710.
JAMA. 1990 Jan 5;263(1):65-8.
The recent development of potential therapies for acute stroke has focused attention on the time delay between stroke onset and presentation. We used the Duke/Veterans Administration stroke registry to collect data about this delay. Results were analyzed using Fisher's Exact Test and ridit analysis. Data from 457 patients at two hospitals were used. Only 42% (192/457) of patients presented within 24 hours of stroke onset, while 25% (116/457) presented within 48 hours and 33% (149/457) presented after 48 hours. Presentation time varied significantly with stroke type. A majority of patients with infarcts (64% [176/276]), stroke-in-evolution (54% [44/81]), and subarachnoid hemorrhage (54% [25/46]) did not present within 24 hours of stroke onset. Most patients with intracerebral hemorrhage (63% [34 of 54]) did present within 24 hours. Reasons for this delay may include patients' lack of awareness about the symptoms of stroke and lack of recognition of early signs by medical personnel. Because of this delay in presentation, a majority of patients may not be candidates for some therapies for acute stroke.
急性中风潜在疗法的最新进展使人们将注意力集中在中风发作与就诊之间的时间延迟上。我们利用杜克大学/退伍军人事务部中风登记处来收集有关这一延迟的数据。使用费舍尔精确检验和参照单位分析对结果进行分析。采用了两家医院457名患者的数据。只有42%（192/457）的患者在中风发作后24小时内就诊，而25%（116/457）在48小时内就诊，33%（149/457）在48小时后就诊。就诊时间因中风类型不同而有显著差异。大多数梗死性中风患者（64% [176/276]）、进展性中风患者（54% [44/81]）和蛛网膜下腔出血患者（54% [25/46]）在中风发作后24小时内未就诊。大多数脑出血患者（63% [54例中的34例]）在24小时内就诊。这种延迟的原因可能包括患者对中风症状缺乏认识以及医务人员未识别早期体征。由于就诊延迟，大多数患者可能不符合某些急性中风疗法的适用条件。
