Analysis of pre-hospital delay times in stroke care

Introduction. Delays in the treatment of a stroke constitute a factor that leads to a more unfavourable prognosis. Shortening the delay time in the health care of these patients is essential in order to reduce the morbidity and mortality rates of this disease. Aims. Our aim was to analyse the causes that bring about delays in getting stroke patients to hospital. Patients and methods. A prospective analysis was conducted of 133 patients who visited the Emergency Department. A survey carried out during the first 48 hours collected information on the clinical characteristics and the steps followed by the patient before arriving at the hospital. We considered the time that elapsed to be adequate if patients arrived at the hospital in less than 2 hours. A univariate and multivariate analysis was performed to evaluate the factors that could extend this time. Results. The mean time elapsed before the patient reached hospital was 502 minutes (interval: 11-5,700). A total of 42.5% arrived in less than 2 hours and 58.2% got there in less than 3 hours. The univariate analysis showed that females, those with a low cultural level, the most severe cases, those who went straight to hospital and those who used the emergency services all arrived more quickly. In the multivariate analysis only the more severe cases and those who went straight to hospital ran less risk of a delayed arrival. Conclusions. The time stroke patients take to reach hospital varies greatly. The main factors that influence the time that elapses before arrival are the severity of the symptoms and going straight to hospital.