Stroke education focusing on recognition and response to decrease pre-hospital delay in India: Need of the hour to save hours
| Autor: | Nitya Suresh, Karthikeyan, Josy J. Vallippalam, Anita Ann Sunny, Saloni Krishna, Rajesh Shankar Iyer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
RD1-811 medicine.medical_treatment Acute ischemic stroke Pre-hospital delay Specific knowledge Tertiary care Odds medicine Time point Stroke education RC346-429 Stroke business.industry Stroke response Thrombolysis Emergency department medicine.disease Hemiparesis Emergency medicine Surgery Neurology (clinical) Neurology. Diseases of the nervous system medicine.symptom business |
| Zdroj: | Interdisciplinary Neurosurgery, Vol 26, Iss, Pp 101309-(2021) |
| ISSN: | 2214-7519 |
| Popis: | Background Pre-hospital delays contribute to late arrival for acute ischemic stroke (AIS) treatment in the emergency department and are an important barrier preventing people from receiving thrombolytic therapy. This study looked into the factors causing pre-hospital delay in a tertiary care centre in South India with the aim of identifying measures to decrease pre-hospital delay. Methods Consecutive cases of AIS from October 2018 to June 2019 were included. A structured questionnaire was used to collect data regarding demographic details, presenting symptoms, time of stroke onset and arrival, mode of transport and knowledge about stroke and thrombolysis. Pre-hospital delay was defined as > 4 h (Considering our door-to-needle time of 30 min) between stroke onset or the time point of wake‐up and the time of arrival. Results Overall, 505 patients were enrolled. Prehospital delay was observed in 352patients (69.7%). The median pre-hospital delay was 9.5 h. In the multivariable analysis, the odds of early arrival were increased in patients who perceived the initial symptoms as serious (OR: 45.57; 95%CI, 11.43–181.63), those with prior knowledge of stroke symptoms (OR: 4.64; 95% CI, 1.86–11.55), those using ambulance services (OR: 3.11; 95% CI, 1.39–6.95), and those developing hemiparesis (OR: 2.50; 95% CI, 1.25–4.97). The odds of early arrival were lower in those visiting their family doctor after the stroke (OR: 0.17; 95%CI, 0.05–0.51). Conclusions Modifiable factors related to stroke recognition and response behavior continue to cause significant pre-hospital delay in India. There is an immediate need for a strong education campaign focusing on stroke specific knowledge to decrease pre-hospital delay. |
| Databáze: | OpenAIRE |
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