Stroke signs knowledge and factors associated with a delayed hospital arrival of patients with acute stroke in Kinshasa.

Autor:	Kazadi Kabanda I; Faculty of Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Kiangebeni Ngonzo C; Faculty of Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Emeka Bowamou CK; Department of Physical Medicine and Rehabilitation, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Divengi Nzambi JP; Department of Internal Medicine, Reference General Hospital, Kinshasa, the Democratic Republic of the Congo., Kiatoko Ponte N; Unit of Neurology, Centre Hospitalier Initiative Plus de Kinkole, Kinshasa, the Democratic Republic of the Congo., Tuyinama Madoda O; Emergency Unit, University Hospital of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Nkodila Natuhoyila A; Department of Biostatistics, Public Health School of Kinshasa, Kinshasa, the Democratic Republic of the Congo., M'buyamba-Kabangu JR; Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Longo-Mbenza B; Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Banzulu Bomba D; Department of Neuropsychiatry, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo., Kianu Phanzu B; Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2024 Mar 24; Vol. 10 (7), pp. e28311. Date of Electronic Publication: 2024 Mar 24 (Print Publication: 2024).
DOI:	10.1016/j.heliyon.2024.e28311
Abstrakt:	Background: Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa. Methods: Patients with stroke and/or accompanying family members were interviewed using a standard questionnaire, and their medical records were reviewed. Factors independently associated with a late arrival (≥4.5 h) to the hospital were identified using the logistic regression test in forward multivariate analysis. Results: Overall, 202 patients with an average age of 57.9 ± 13.1 years were included. Only 27 (13.4%) patients immediately associated the initial symptoms with a stroke episode. Delayed hospital arrival was observed in 180 (89.1%) patients. Unmarried status (adjusted odds ratio [aOR], 2.29; 95% confidence interval [CI], 1.17-4.88; p = 0.007), low education level (aOR, 2.29; 95% CI, (1.12-5.10; p = 0,014), absence of impaired consciousness (aOR, 3.12; 95% CI, 1.52-4.43; p = 0.005), absence of a history of hypertention (aOR, 1.85; 95% CI, 1.18-3.78; p = 0.041), absence of a history of diabetes (aOR, 1.93; 95% CI, 1.15-4.58; p = 0.013), heavy alcohol consumption (aOR, 1.83; 95% CI, 1.12-2.83; p = 0.045), absence of a severe to very severe stroke (aOR, 4.93; 95% CI, 0.82-1.01; p = 0.002), and presence of ischemic stroke (aOR, 2.93; 95% CI, 1.54-4.59; p = 0.001) were identified as independent determinants of delayed hospital arrival. Conclusions: This study depicted a low stroke awareness rate and a much longer prehospital delay than evidence-based guidelines recommend and identified eight factors that public health actions could target to promote the earliest management of stroke. Competing Interests: All authors do not have competing interest. (© 2024 The Authors. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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