[Factors of importance for early and late admission of patients with stroke and transient cerebral ischemia].
BACKGROUND
Early admission after stroke and TIA is important in modern stroke treatment. We studied the time delay to admission and explored predictive factors of early/late admission.


METHODS
The study was prospective and community-based comprising all patients with stroke or TIA admitted to a Copenhagen hospital from 1 September 1999 to 30 April 2000. The catchment area is well defined with 283,000 inhabitants. All had a neurological examination and a structured interview within three days with registration of age, gender, premorbid Rankin, Scandinavian stroke scale score, time of onset, knowledge of the cause of symptoms, cohabitation, alone at onset, whether admitted by a general practitioner (GP) or by ambulance after calling emergency, and relevant stroke risk factors. Univariate and multivariate statistics were used.


RESULTS
Altogether 494 patients with stroke and 63 with TIA were entered; 49% were admitted by a GP, 38% by ambulance after calling emergency, 13% via other routes. Time from onset to hospital admission could be assessed reliably in 374 patients (67%) and was a median of 2.6 hours; 37% arrived within 0-3 hours, 55% within 0-6 hours. Patients calling an ambulance over emergency arrived at a median of 1.0 hour after the stroke; those calling the GP a median of 6.0 hours after the stroke. In a multivariate analysis only admission by ambulance after calling emergency (OR 5.7), TIA (OR 5.6), or the patient's knowledge of the cause of the symptoms (OR 2.2) were predictors of early admission.


CONCLUSIONS
Patients with stroke or TIA in a Danish metropolitan area arrive at hospital a median of 2.6 hours after the stroke. Admission by ambulance after calling emergency was associated with the shortest onset to admission time.
Rasmussen
Berit H
BH
Neurologisk afdeling, Amtssygehuset i Gentofte, DK-2900 Hellerup.
Germer
Ulla
U
Kammersgaard
Lars Peter
LP
Olsen
Tom Skyhøj
TS
D000368:Aged; D000552:Ambulances; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D015912:Thrombolytic Therapy; D013997:Time Factors