Factors influencing pre-hospital delay after ischemic stroke and transient ischemic attack

Abstract

Background and Purpose: We investigated which factors influence pre-hospital delay after the onset of stroke and transient ischemic attack (TIA). Methods: A total of 113 patients with ischemic stroke or TIA who were directly transported to the emergency room within 24 hours of onset were entered into the study. We analyzed factors relating to an early arrival at hospital (≤2 hours), and factors relating to an early emergency call (≤1 hour). Results: The interval between symptom onset and arrival at hospital was within 2 hours in 75 (66%) patients. The interval between symptom onset and call to emergency was significantly related to arrival within 2 hours (p<0.001), whereas time (p=0.09) and distance (p=0.32) for transportation were not. The interval between onset and emergency call was within 1 hour in 68 patients (60%). The presence of a bystander (Odds ratio 3.68) and consciousness disturbance (Odds ratio 2.49) were independently related to an early emergency call. Conclusion: An early emergency call is essential for the timely admission of stroke patients into a hospital. The presence of a bystander and consciousness disturbance are keys to an early emergency call. © 2009 The Japanese Society of Internal Medicine.