Gupta Amit Kumar, Kaur Kamaldeep, Bhatia Lovleen, Kaur Rupinderjeet, Bhaskar Ajay, Singh Gurpreet
Department of Cardiology, Dayanand Medical College & Hospital, Ludhiana, Ludhiana, IND.
Department of Medicine, Government Medical College and Rajindra Hospital Patiala, Patiala, IND.
Cureus. 2023 May 18;15(5):e39180. doi: 10.7759/cureus.39180. eCollection 2023 May.
Background Pre-hospital delay, which refers to the time delay between the development of symptoms in the patient and the start of treatment, is one of the major factors impacting the treatment of stroke. This study aimed to identify patient characteristics and factors causing a pre-hospital delay in acute stroke (both ischemic and hemorrhagic) cases. Methodology This prospective follow-up study included 100 patients who presented with clinical features of acute stroke within 48 hours of symptom onset. A pre-designed questionnaire was administered within 72 hours of hospital admission to every patient. Results The mean time to hospital presentation was 7.73 hours. Only 2% of patients were thrombolysed. Age group, gender, education status, occupation, and socioeconomic status were not significantly (p > 0.05) associated with the mean symptom onset time to hospital arrival. Rural area (p < 0.001), nuclear family (p = 0.004), distance from the tertiary care center (p < 0.001), being alone at the time of symptom onset (p < 0.001), lack of knowledge about symptoms of stroke in patient/attendant (p < 0.001), and mode of transport were the factors that emerged as significant predictors of pre-hospital delay on univariate analysis. Living in a nuclear family, distance from the tertiary care center, and mode of transport were the factors that emerged as independent predictors of pre-hospital delay on multiple linear regression analysis. Conclusions In this study, factors associated with delayed hospital presentation including living in a nuclear family, distance from the tertiary care center, and use of public transport to reach the hospital emerged as independent predictors of pre-hospital delay.
背景 院前延误是指患者出现症状至开始治疗之间的时间延迟，是影响卒中治疗的主要因素之一。本研究旨在确定急性卒中（包括缺血性和出血性）病例中导致院前延误的患者特征和因素。方法 这项前瞻性随访研究纳入了100例在症状发作48小时内出现急性卒中临床特征的患者。在患者入院72小时内对每位患者进行预先设计的问卷调查。结果 平均就诊时间为7.73小时。仅2%的患者接受了溶栓治疗。年龄组、性别、教育程度、职业和社会经济状况与平均症状发作至入院时间无显著相关性（p>0.05）。农村地区（p<0.001）、核心家庭（p=0.004）、距三级医疗中心的距离（p<0.001）、症状发作时独自一人（p<0.001）、患者/陪护人员对卒中症状缺乏了解（p<0.001）以及交通方式是单因素分析中出现的院前延误的显著预测因素。在多元线性回归分析中，核心家庭居住情况、距三级医疗中心的距离和交通方式是院前延误的独立预测因素。结论 在本研究中，与延迟入院相关的因素，包括核心家庭居住情况、距三级医疗中心的距离以及使用公共交通前往医院，是院前延误的独立预测因素。
