Alkhotani Amal, Alharbi Yousef, Alghamdi Hadeel, Alshareef Hadeel, Abdulmuttalib Jannat A, Alsulami Amal, Alharbi Abdulaziz
Neurology, King Abdullah Medical City, Mecca, SAU.
Medicine, Umm Al-Qura University, Faculty of Medicine, Mecca, SAU.
Cureus. 2022 Sep 7;14(9):e28878. doi: 10.7759/cureus.28878. eCollection 2022 Sep.
Introduction Stroke has become one of the most severe causes of long-term neurological impairment and disability and is considered one of the leading causes of mortality worldwide. This study aimed to determine time delays in stroke patients from symptoms onset to treatment with tissue plasminogen activator (tPA) initiation in King Abdullah Medical City Specialist Hospital, Makkah, Saudi Arabia. Patients and methods We reviewed 81 patients who suffered from acute stroke. The data were collected from patients' electronic and paper files. Patients were divided into two main categories based on interval time from recognition of symptoms to tPA treatment. Patients were divided into early treatment, if the duration was less than or equal to 120 minutes, and delayed treatment, if the interval time was more than 120 minutes. Results Nearly two-thirds (64.2%) were males, and more than half (5.6%) were in the older age group (>65 years). Patients who underwent thrombectomy were 7.4%. The mean value of the National Institutes of Health Stroke Scale (NIHSS) score was 10.7 (SD: 7.14). The mean time from symptoms onset to arrival at the hospital was 82.4 (SD: 44.1) minutes, while the total time from recognition of symptoms to tPA treatment was 154 (SD: 50.8) minutes. The prevalence of patients with delayed treatment was 72.8%, and the rest were assumed to have early treatment (27.2%). None of the socio-demographic variables were predicted to influence delayed treatment. Conclusion A significant number of patients were delayed in treatment. Patients' socio-demographic data and NIHSS scores seem to have no significant effect on delayed treatment. Further research is needed to establish the delay in time for pre-hospital and in-hospital treatment of stroke patients.
引言
中风已成为导致长期神经功能障碍和残疾的最严重原因之一，被认为是全球主要死因之一。本研究旨在确定沙特阿拉伯麦加阿卜杜拉国王医疗城专科医院中风患者从症状发作到开始使用组织纤溶酶原激活剂（tPA）治疗的时间延迟情况。
患者与方法
我们回顾了81例急性中风患者。数据从患者的电子和纸质病历中收集。根据从症状识别到tPA治疗的间隔时间，将患者分为两大类。如果持续时间小于或等于120分钟，则分为早期治疗组；如果间隔时间超过120分钟，则分为延迟治疗组。
结果
近三分之二（64.2%）为男性，超过一半（5.6%）为老年组（>65岁）。接受血栓切除术的患者占7.4%。美国国立卫生研究院卒中量表（NIHSS）评分的平均值为10.7（标准差：7.14）。从症状发作到入院的平均时间为82.4（标准差：44.1）分钟，而从症状识别到tPA治疗的总时间为154（标准差：50.8）分钟。延迟治疗患者的患病率为72.8%，其余被认为是早期治疗（27.2%）。没有社会人口统计学变量被预测会影响延迟治疗。
结论
大量患者治疗延迟。患者的社会人口统计学数据和NIHSS评分似乎对延迟治疗没有显著影响。需要进一步研究以确定中风患者院前和院内治疗的时间延迟情况。
