October 1, 2019-November 30, 2020
Background and Purpose -Stroke remains to be one of the leading causes of morbidity and mortality worldwide. The importance of early intervention in stroke is well known to prevent permanent disability and mortality. This study was conducted to determine the average length of time it takes for patients to consult a health care personnel or facility from the time of symptom onset, to identify factors causing such delays and to determine the association between delayed consults and outcomes after stroke.
Methods - This is a prospective, observational cross-sectional study that determined the factors causing delays in consult among stroke patients in a tertiary hospital. Patients >18 years old, with signs and symptoms as well as neuroimaging findings consistent with stroke, who sought consult at the Baguio General Hospital and Medical Center Emergency Room >4.5 hours from symptom onset were included as participants. A questionnaire was administered to determine participants' demographic data, duration of symptoms, average time of delay in seeking consult and the factors causing such delays. A chart review was conducted to determine stroke severity upon admission and outcomes on discharge.
Results - Fifty-eight participants were included in the study. Among the factors identified, geographical location (p=0.022) and referral from other hospitals or health care providers (p=0.004) were significantly associated with longer pre-hospital delays in consults to a stroke ready hospital. There was no significant association between delayed consult and mortality but participants with longer pre-hospital delays were significantly associated with severe disability (mRS 3-5) on discharge.
Conclusions - Addressing the identified factors causing pre-hospital delays can improve the current underutilization of reperfusion strategies or surgical interventions available in the locality with the ultimate goal of improving patient outcomes after stroke.
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