Recognizing the Symptoms and Prehospital Delay of Patients with Acute Stroke

Cilj istraživanja: Cilj istraživanja bio je ispitati prehospitalno kašnjenje i uzroke kašnjenja. Nacrt studije: Prospektivno-kohortna studija. Ispitanici i metode: Istraživanje smo proveli na 100 pacijenata kojima je kompjuteriziranom tomografijom dijagnosticiran moždani udar. Upitnikom smo skupljali podatke o dobi, spolu, vrsti moždanog udara, s kime živi pacijent, uzroke kašnjenja, vrijeme početka simptoma i dolaska na osječki Objedinjeni hitni bolnički prijem. Rezultati: Medijan vremena kašnjenja pacijenata iznosi 141,5 minuta. Više od polovine pacijenata, njih 56 (56 %) došlo je u bolnicu unutar prva tri sata od nastupa simptoma, dok je u prvih šest sati došlo 78 (78 %) pacijenata. Pacijenti sa subarahnoidalnom hemoragijom u bolnicu su stizali najbrže, a najduže vrijeme kašnjenja imali su pacijenti s moždanim udarom velikih krvnih žila, no nema statistički značajne razlike između vremena kašnjenja u odnosu na vrstu moždanog udara, kao niti između vremena kašnjenja u odnosu na dob i spol. Pacijenti koji žive s više članova kućanstva najbrže su stizali u bolnicu, no također statistički značajna razlika nije pronađena. 49 (49 %) pacijenata je kao uzrok kašnjenja navelo čekanje transporta. Zaključak: Rezultati našeg istraživanja prilično su dobri, ali i dalje nezadovoljavajući u prepoznavanju simptoma i brzini dolaska na hitni prijem. Budući da se tromboliza i trombektomija primjenjuju unutar prvih nekoliko sati od nastupa bolesti, potrebna je edukacija stanovništva kako bi se što većem broju pacijenata omogućile suvremene metode liječenja. Postoji i dalje veliki prostor za skraćivanje prehospitalnog kašnjenja i raniji dolazak pacijenata u bolnicu.Objectives: The aim of this study was to research pre-hospital delay and its causes in patients suffering from acute stroke. Study design: Prospective-cohort study Participants and methods: The research included 100 patients diagnosed with acute stroke by computed tomography. The questionnaire was used to gather data related to age, sex, acute stroke type, members of the patients’ household, causes of delay, time of the symptoms onset and time of arrival at the Unified emergency hospital admissions in Osijek. Results: Delay median is 141.5 minutes. More than a half of patients, 56 of them (56 %), arrived to the hospital within the first three hours of the symptoms onset, while 78 patients (78 %) arrived within the first six hours. Patients suffering from subarachnoid hemorrhage were the first to arrive to the hospital, while it took the longest for the patients with large-vessel ischemia to arrive to the hospital. Nevertheless, the significant statistical difference was not observed in the arrival time or in relation to sex and age. Patients who live in a household with more members arrived sooner to the hospital, but statistically significant difference was not found in this aspect either. There were 49 patients (49 %) who identified belated transport as the main cause of delay. Conclusion: The results of this research are quite good, but not completely satisfying in symptoms recognition and the time it takes to arrive to the emergency hospital admissions. Since thrombolysis and thrombectomy can only be performed within the first few hours of the symptoms onset, it is necessary to educate people on acute stroke do that higher number of patients could receive those treatments. There is still room for improvement when it comes to pre-hospital delay and the time of arrival to the hospital