Factors associated with delayed admission to hospital of ischemic stroke patients–A cross–sectional observational study

Dr Rajiv Ratan Singh Yadav; Dr Shiv Shanker Tripathi; Dr Sachin Avasthi; Dr Deepak Malviya; Dr Abhishek Chauhan; Prof AK Thakkar

Volume : VI, Issue : II, February - 2017

Factors associated with delayed admission to hospital of ischemic stroke patients–A cross–sectional observational study

Dr Rajiv Ratan Singh Yadav, Dr Shiv Shanker Tripathi, Dr Sachin Avasthi, Dr Deepak Malviya, Dr Abhishek Chauhan, Prof Ak Thakkar

Abstract :

Objective: To evaluate the factors associated with delayed admission to hospital of ischemic stroke patients. Methods: This was a cross sectional observational study conducted in the Emergency Department in a tertiary care hospital in north India. All eligible patients clinically diagnosed as stroke (As defined by WHO. A clinical syndrome consisting of rapidly developing clinical signs of focal (or global in case of coma) disturbance of cereal function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin) were included in this study. The delay was defined as >6 hour between the onset of stroke and reaching at the hospital. Results: Majority of ischemic stroke was occurred at home (76.6%) followed by workplace (4.9%) and hospital (2.5%). More than one third of the patients reached hospital by own vehicle (40.6%) followed by rented vehicle (26.2%), private ambulance (19.3%) and government ambulance (13.9%). Out of the total 244 patients, 153 (62.7%) reached at the hospital after 6 hours (delayed). The lack of finance was found be the main reason for delay (43.8%). Delay in decision making was in 31.4% of patients and delay due to treatment at other centre was in 24.2% of the patients. Conclusion: We have found that the main reason behind this, is the inability to identify the symptoms of stroke, contact with a local doctor/village doctor, indecision and lack of transport facilities.