title: Time to emergency department arrival and its determinants in patients with acute ischemic stroke.
abstract: We sought to describe the delay between stroke symptom onset and emergency department (ED) arrival and to determine the role of seven specific variables in explaining the delay. This prospective study employed the database of an urban stroke center. Database information was derived from ED records and postadmission interviews. For 64 patients with a known time of symptom onset, the delay between symptom onset and ED arrival was dichotomized (< or = 2 hours, > 2 hours). In bivariate analysis, higher NIH Stroke Scale (NIHSS) scores, initial contact with emergency medical services (EMS), transportation by EMS, previous stroke, and awareness of stroke were associated (P < .05) with less delay. In the multivariable model, higher NIHSS scores and previous stroke were independent predictors of early ED arrival. The sense of urgency shown by patients with more severe strokes or a previous stroke must be demonstrated by others if delays are to be minimized.
authors.affiliation: Institute of Outcomes Research and Evaluation, Hartford Hospital, Department of Physical Therapy, School of Allied Health, University of Connecticut, Storrs, USA. rbohann@harthosp.org
authors.forename: Richard W
authors.initials: RW
authors.lastname: Bohannon
authors.forename: Isaace E
authors.initials: IE
authors.lastname: Silverman
authors.forename: Martha
authors.initials: M
authors.lastname: Ahlquist
mesh_terms: D000208:Acute Disease; D002545:Brain Ischemia / Q000175:diagnosis* / Q000188:drug therapy*; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D013997:Time Factors; D014187:Transportation of Patients