Faculty of Public Health, Lebanese University, Fanar, Lebanon.
Faculty of Pharmacy, Lebanese University, Hadath, Lebanon.
BMC Neurol. 2022 Dec 20;22(1):494. doi: 10.1186/s12883-022-03018-0.
Hospital arrival time after acute ischemic stroke onset is the major factor limiting the eligibility of patients to receive intravenous thrombolysis. Shortening the prehospital delay is crucial to reducing morbidity and mortality for stroke patients. The study was conducted to investigate the factors that influence hospital arrival time after acute stroke onset in the Lebanese population and to assess the effect of the prehospital phase on patients' prognosis at discharge.
A prospective cross-sectional study was performed in eleven hospitals from April to July 2021 including 100 patients having stroke symptoms or transient ischemic attack (TIA). Two questionnaires were used to collect data addressing patient management in the pre-hospital phase and the in-hospital phase. Descriptive and bivariate analyses were done to evaluate the potential associations between prognosis, pre-hospital characteristics, and other factors.
The patients' mean age was 70.36 ± 12.25 years, 43 (53.8%) of them were females, and 79 (85%) arrived within 3 hours after symptoms onset. Diabetic patients had a significant delay in hospital arrival compared with non-diabetics (27.0%vs.7.1%, p-value = 0.009). Moreover, 37 (75.5%) of school-level education patients arrived early at the hospital compared to 7 (100%) of university-level education (p-value = 0.009). The modified Rankin Scale (mRS) at discharge in patients with hemorrhagic stroke (10 (90%)) was worse than that in patients with ischemic stroke (38 (80%)) or TIA (3 (15%)) (p-value< 0.001).
The study findings make it imperative to raise awareness about stroke symptoms among the Lebanese population. Emergency Medical Services should be utilized appropriately in the transportation of stroke patients to achieve optimal patient outcomes.
急性缺血性脑卒中发病后到医院的时间是限制患者接受静脉溶栓治疗的主要因素。缩短院前延误时间对于降低脑卒中患者的发病率和死亡率至关重要。本研究旨在调查影响黎巴嫩人群急性脑卒中发病后到医院时间的因素，并评估院前阶段对患者出院时预后的影响。
2021 年 4 月至 7 月，在 11 家医院进行了一项前瞻性横断面研究，共纳入 100 例有脑卒中症状或短暂性脑缺血发作（TIA）的患者。使用两份问卷收集患者在院前和院内阶段的管理数据。进行描述性和双变量分析，以评估预后、院前特征和其他因素之间的潜在关联。
患者的平均年龄为 70.36±12.25 岁，43 例（53.8%）为女性，79 例（85%）在症状发作后 3 小时内到达医院。与非糖尿病患者相比，糖尿病患者到达医院的时间明显延迟（27.0%比 7.1%，p 值=0.009）。此外，与大学学历患者相比，中学学历患者中有 37 例（75.5%）更早到达医院（p 值=0.009）。出血性脑卒中患者出院时改良 Rankin 量表（mRS）为 10（90%），比缺血性脑卒中患者（38（80%））或 TIA 患者（3（15%））更差（p 值<0.001）。
研究结果表明，有必要提高黎巴嫩人群对脑卒中症状的认识。应适当利用紧急医疗服务来转运脑卒中患者，以实现最佳的患者结局。
