Khalema Diteboho, Goldstein Lara N, Lucas Susan
Department of Radiology, University of the Witwatersrand, South Africa.
Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
SA J Radiol. 2018 Jun 21;22(1):1319. doi: 10.4102/sajr.v22i1.1319. eCollection 2018.
Stroke presents commonly to the emergency department (ED), and is a common cause of morbidity and mortality in South Africa. Early ED presentation and early neuroimaging are required in order for thrombolysis to be a potential therapeutic modality.
To determine the time to ED presentation, time to computed tomography (CT) scan and the potential influencing factors for patients with stroke.
A retrospective record review of all patients who presented with clinical features of stroke to a tertiary academic ED in Johannesburg, South Africa, from 01 January to 31 December 2014.
Data from 232 eligible stroke patients were analysed. The median time to presentation to the ED was 33 h with the majority of patients (81.3%) presenting after the 4.5 h window for thrombolysis. The median time to CT was 8 h. Only 3.9% of patients had a CT scan within one hour of arrival. Patients with loss of consciousness were associated with earlier hospital presentation ( = 0.001). None of the patients were thrombolysed.
Patients with stroke commonly present late to hospital. If we are to make a difference in this group of vulnerable patients, further education and training needs to be emphasised regarding 'time is brain'. Communication and commitment is also required by the emergency medical services, ED and radiology staff in order to prioritise stroke patients and to reduce delays.
中风是急诊科的常见病症，也是南非发病和死亡的常见原因。为了使溶栓成为一种潜在的治疗方式，需要尽早到急诊科就诊并尽早进行神经影像学检查。
确定中风患者到急诊科就诊的时间、进行计算机断层扫描（CT）的时间以及潜在影响因素。
对2014年1月1日至12月31日期间在南非约翰内斯堡一家三级学术急诊科出现中风临床症状的所有患者进行回顾性记录审查。
分析了232例符合条件的中风患者的数据。到急诊科就诊的中位时间为33小时，大多数患者（81.3%）在溶栓的4.5小时时间窗之后就诊。进行CT检查的中位时间为8小时。只有3.9%的患者在到达后1小时内进行了CT扫描。意识丧失的患者到医院就诊时间较早（P = 0.001）。没有患者接受溶栓治疗。
中风患者通常到医院就诊较晚。如果我们要对这群脆弱的患者有所帮助，就需要进一步强调“时间就是大脑”的教育和培训。急诊医疗服务人员、急诊科和放射科工作人员也需要进行沟通并做出承诺，以便优先处理中风患者并减少延误。
