engleski

Time of Delay of stroke Patients of Eastern Croatia

Background and purpose: Thrombolytic therapy improves the outcome after ischemic stroke when applied within 3 hours from symptoms onset. Problem often is that only a minor part of patients arrives within that time frame. The aim of this study was to investigate what was the time of delay after acute stroke and which factors contribute to the late arrival. Patients and methods: In this prospective one-center study time of delay and main reasons for it were evaluated in 200 patients (96 males and 104 females, 48% and 52%, respectively) admitted to the University Hospital Osijek, Eastern Croatia. Average age of all patients was 69.98 years. Time of delay was defined as the time from symptoms onset to the hospital arrival. Reasons for delay indicated by patients were divided in three main groups: non-recognized symptoms, no knowledge about urgency and late transport. Results: The mean interval of time of delay was 502 minutes, 254 minutes for hemorrhagic stroke, and 542 minutes for ischemic stroke. Time of delay was shortest in patients with subarachnoid hemorrhage (240 minutes) and longest in small vessel stroke (804 minutes). Among investigated patients, only 40% arrived within 3 hours, and another 13% in the next 3 hours, i.e. 53% within 6 hours. The most frequent reason for delay was non-recognized symptoms (52.5%), followed by late transport (33.5%) and finally no knowledge about urgency (14%). Conclusions: Our results show significant prehospital delay for acute stroke patients in Eastern Croatia. This emphasizes the requirement of effective public health activities and efficient system of urgent medicine, which should reduce time of delay and improve the outcome of therapy.

Stroke; Thrombolytic therapy; Time of Delay

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