Soto V Álvaro, Morales I Gladys, Echeverría V Gonzalo, Belén Colinas G María, Canales O Pedro, Contreras B Daniela
Departamento de Especialidades Médicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
Centro de Investigación en Epidemiología Cardiovascular y Nutricional, Universidad de La Frontera, Temuco, Chile.
Rev Med Chil. 2019 Sep;147(9):1154-1158. doi: 10.4067/s0034-98872019000901154.
Stroke is a time-dependent emergency. Most patients with acute ischemic stroke are excluded from reperfusion therapies due to late consultation.
To estimate the arrival times of patients with stroke to the Emergency Room (ER) of a public hospital. To identify factors associated with early consultation.
A convenience sample, 583 patients aged 71 ± 13 years (55% males) consulting for stroke at an emergency room was analyzed in terms of delay between onset of symptoms and arrival to the ER, demographics and etiology of stroke.
The admission diagnoses were ischemic stroke in 76%, intracerebral hemorrhage in 12%, transient ischemic attack in 9% and subarachnoid hemorrhage in 3%. The median time of arrival was 8 hours and 11 minutes after the onset of symptoms. Nineteen percent of consultations for ischemic stroke occurred within 3 hours of symptom onset, and 38% within 6 hours. In the logistic regression analysis, having an address near the hospital and the severity of stroke were associated with early consultation with a combined odds ratio of 5.97 (95% confidence intervals 3.23-11.04).
There were significant differences in the arrival times of patients with stroke. Only a low proportion of patients with ischemic stroke consulted within the window for reperfusion therapies. Severe strokes and living near the hospital were associated with early consultation.
中风是一种时间依赖性急症。大多数急性缺血性中风患者因就诊延迟而被排除在再灌注治疗之外。
评估中风患者到达公立医院急诊室（ER）的时间。确定与早期就诊相关的因素。
对一个便利样本进行分析，该样本包括583名年龄为71±13岁（55%为男性）在急诊室因中风就诊的患者，分析症状发作与到达急诊室之间的延迟、人口统计学特征及中风病因。
入院诊断为缺血性中风的占76%，脑出血的占12%，短暂性脑缺血发作的占9%，蛛网膜下腔出血的占3%。到达的中位时间为症状发作后8小时11分钟。19%的缺血性中风就诊发生在症状发作后3小时内，38%发生在6小时内。在逻辑回归分析中，住址靠近医院和中风严重程度与早期就诊相关，合并比值比为5.97（95%置信区间3.23 - 11.04）。
中风患者的到达时间存在显著差异。只有一小部分缺血性中风患者在再灌注治疗的时间窗内就诊。严重中风和居住在医院附近与早期就诊相关。
