设拉子沙希德拉贾伊医院急性卒中患者延迟因素及到达医院时间的研究（2022 - 2023年），托尼卡本

Study on delay factors and time to hospital arrival after acute stroke in patients at Shahid Rajaei hospital, Tonekabon (2022-2023).

作者信息

Farokhfar Mohadeseh, Almani Mohamad Saleh Pezeshki

机构信息

Department of Neurology, Mazandaran University of Medical Sciences, Ramsar Campus, Ramsar, Iran.

Student Research Committee, Shahid Rajaei Hospital, Mazandaran University of Medical Sciences, Tonekabon, Iran.

出版信息

BMC Neurol. 2025 Aug 13;25(1):340. doi: 10.1186/s12883-025-04361-8.

DOI:10.1186/s12883-025-04361-8

PMID:40804361

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12351997/

Abstract

BACKGROUND

Stroke is a sudden focal neurological deficit caused by vascular damage to the central nervous system. Globally, stroke is a leading cause of death and disability, with a particularly significant burden in low- and middle-income countries. In Iran, the incidence of acute stroke is increasing, and the age of onset is lower compared to developed countries. This study examines factors causing pre-hospital delays in acute stroke patients at Shahid Rajaei Hospital, Tonekabon, North of Iran (2022-2023). Timely intervention is critical for improving outcomes, as delays significantly affect treatment effectiveness. This study aims to identify the primary causes of pre-hospital delays in acute stroke patients and provide actionable insights to enhance timely intervention strategies, ultimately improving patient outcomes.

METHODS

A retrospective descriptive-analytical study was conducted on 150 acute stroke patients using census sampling. Data included demographics, symptoms, and time intervals from onset to hospital arrival. Analysis was performed with SPSS using chi-square, T-tests, and ANOVA.

RESULTS

Of the 150 patients, 81.3% arrived over 4.5 hours after symptom onset, missing the thrombolytic treatment window. Statistical analysis revealed significant associations between some demographic and clinical factors: shorter distances to the hospital and faster arrival (p = 0.037), presence of a witness (p = 0.041), and stroke onset during the daytime (p = 0.002) were linked to reduced delays. Marital status also influenced arrival times significantly (p = 0.007). Other delay factors included unawareness of stroke symptoms (46%), being alone (14.7%), and symptoms occurring during sleep (8.6%).

CONCLUSIONS

The study highlights the need for public education on stroke symptoms and improved emergency systems to reduce delays. Addressing these gaps can enhance patient outcomes, especially in areas with limited awareness and resources.

摘要

背景

中风是由中枢神经系统血管损伤引起的突发性局灶性神经功能缺损。在全球范围内，中风是导致死亡和残疾的主要原因，在低收入和中等收入国家负担尤为沉重。在伊朗，急性中风的发病率正在上升，且发病年龄比发达国家更低。本研究调查了伊朗北部通卡本市沙希德拉贾伊医院急性中风患者院前延误的相关因素（2022 - 2023年）。及时干预对于改善预后至关重要，因为延误显著影响治疗效果。本研究旨在确定急性中风患者院前延误的主要原因，并提供可采取行动的见解以加强及时干预策略，最终改善患者预后。

方法

采用普查抽样法对150例急性中风患者进行回顾性描述性分析研究。数据包括人口统计学信息、症状以及从发病到入院的时间间隔。使用SPSS进行卡方检验、T检验和方差分析。

结果

150例患者中，81.3%在症状发作后超过4.5小时才到达医院，错过了溶栓治疗窗口。统计分析显示，一些人口统计学和临床因素之间存在显著关联：到医院距离较短和到达速度较快（p = 0.037）、有目击者（p = 0.041）以及中风在白天发作（p = 0.002）与延误减少有关。婚姻状况也对到达时间有显著影响（p = 0.007）。其他延误因素包括对中风症状不了解（46%）、独自一人（14.7%）以及症状在睡眠期间出现（8.6%）。