Hospital arrival times and delay before acute stroke patients receive neurological care. Analysis of a national multi-centre registry: EPICES registry (II)

Introduction. Delays on arrival time and specialized care at hospital are still the first cause that hampers the application of best possible treatments to the stroke patients. Aim. To analyze the arrival time to the hospital up to the neurological care of patients, in a multicentric series of stroke patients. Patients and methods. The EPICES registry is an observational and prospective study performed with a methodology of registering consecutive clinical records of stroke patients admitted to the hospital under neurological attention. The sample used to analyze starting-door times it was 5,454 patients, for the door-neurologist time it was 5,379 patients, and for the time of stay at ER room it was 5,825 patients. Results. 90% of the patients presented a stroke between 8 and 24 h. The season of the year had no influence on the frequency, neither on the distribution of stroke type. onset-door time was 264.1 +/- 318.3 minutes; 34.7% of the patients arrived to the hospital during the first hour after the onset of the symptoms, and 63.7% of them arrived during the first three hours. Door-neurologist time was 378.1 +/- 731.4 minutes; patients' age (p < 0.0001) and previous strokes (p < 0.0001) significantly prolonged such time. The availability of neurologist on call at the emergency service and of stroke units were associated to a significant reduction of hospital indoor times. Conclusion. In relation to previous data, current study shows an important reduction of onset-door and door-neurologist times.