Sintayehu Robel, Tinsae Tsion, Kefyalew Merahi
Department of Emergency and Critical Care Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Neurol. 2025 May 3;25(1):194. doi: 10.1186/s12883-025-04209-1.
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.
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.
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.
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.
急性中风后及时就医对于有效治疗和改善患者预后至关重要。然而，急性中风后延迟的医疗干预会导致死亡率和发病率增加。本研究探讨了导致中风患者在急诊科延迟就诊的因素。
在亚的斯亚贝巴的一家转诊医院进行了为期9个月的前瞻性横断面研究。数据通过在中风患者或其护理人员到达急诊科时发放问卷收集。进一步查阅电子病历，治疗医生描述了患者到达急诊科后的后续治疗情况。使用描述性和分析性参数对数据进行分析。
只有33.3%（n = 30）的患者在4.5小时内到达急诊科。出血性中风是早期到急诊科就诊的统计学显著预测因素（OR = 3.182；95% CI（1.258 - 8.046）；p = 0.036）。未使用任何药物是早期就诊的另一个边缘显著预测因素（OR = 2.555；95%（0.936 - 6.970）；p = 0.067）。延迟就诊的边缘显著预测因素之一是药物依从性低（OR = 0.224；95% CI（0.48 - 1.044）；p = 0.057）。其他与到达时间有关的因素，虽然无统计学意义，但包括教育程度、对中风严重性的认知以及到达急诊科之前的健康就诊次数。
研究发现，除了中风类型外，许多导致延迟就医的因素是可以改变的。适当当局的干预也可以对住院时间产生积极影响。
