Missed golden hours of stroke patients at Zweditu Memorial Hospital in Addis Ababa, Ethiopia.

BACKGROUND

Seeking medical attention promptly after an acute stroke is essential for effective treatment and improved patient outcomes. However, delayed medical intervention after acute stroke contributes to increased mortality and morbidity. This study explored factors that contribute to the delayed appearance of stroke patients at the emergency department.

METHODS

A prospective cross-sectional study was conducted for 9 months at a referral hospital in Addis Ababa. Data was collected using questionnaires administered to stroke patients or their caregivers upon their arrival at the emergency department. Electronic medical records were further reviewed, and the treating physicians described the subsequent management of the patient after their arrival at the emergency department. Data was analyzed using descriptive and analytic parameters.

RESULTS

Only 33.3% (n = 30) arrived at the emergency department within 4.5 h. Hemorrhagic stroke was a statistically significant predictor of early presentation to the emergency department (OR = 3.182; 95% CI (1.258-8.046); p = 0.036). The absence of any substance was another marginally significant predictor for early appearance (OR = 2.555; 95% (0.936-6.970); p = 0.067). One of the marginally significant predictors for late presentation was low drug adherence (OR = 0.224; 95% CI (0.48-1.044); p = 0.057). The other factors attributed to the time of arrival, though not statistically significant, were level of education, perception of stroke as a serious illness, and prior number of health visits before arrival to the emergency department.

CONCLUSION

The study found that many of the factors that cause delays in getting to the hospital can be changed, except for the type of stroke. Time spent in the hospital could also be positively impacted by the intervention from the appropriate authorities.