A CLINICAL INVESTIGATION ON THE CAUSES OF THE PREHOSPITAL DELAY IN ACUTE STROKE CARE

The aim of our study was to investigate the factors which cause prehospital delays in acute stroke care. We prospectively studied 229 acute stroke patients (median age: 71 +/- 19 years, 90female) who presented to the Emergency Department (ED) of the Gilhane Military Teaching Hospital, Haydarpaia, istanbul. Prehospital delay was defined as time from symptom onset to the ED arrival (symptom onset to ED door). The delay was the time interval between the medical call for help and transportation time. The information regarding with the history, call for medical help and to assess the transportation time were obtained retrospectively from the conscious patients or from the medical personal or relatives of the unconscious patients. We utilized SPSS for Windows 10.0 pocket program for the statistical analysis. The dependent variables (age, sex, co-morbidity, etc.) which affect the prehospital intervention time of the stroke patients were analyzed by logic log linear analysis. We have found the median interval of prehospital and emergency delays as 92.66 minutes and 53 minutes for all patients, respectively. The major cause of the prehospital delay was the time from symptom onset to first call for medical help ([68.21 minutes], [73.93%]). The analysis of clinical outcomes which affects the prehospital delay in stroke patients were advanced age (> 65), unaware of symptoms, suffering stroke previously, co-morbidity and low National Institutes of Health Stroke Scale (NIHSS) which were reported as the patients variables. The time interval for the call for medical help must be shortened in order to reduce the prehospital delay in acute stroke patients. To reduce time interval, individually, the person with advanced age at high risk for stroke or with comorbidity, and their relatives must be trained by the medical people in terms of learning the specific and nonspecific findings of acute stroke. Besides, we believe that the educational campaigns which will be held or supported by the media and the medical facilities, will give a rise an important time reduction for the medical call.