title: Patient and hospital delays in acute ischaemic stroke in a Dublin teaching hospital.
abstract: A limiting factor for thrombolysis in ischaemic stroke is delayed presentation to hospital. Prolonged A&E stay and delayed rehabilitation affects care. We evaluated the delay in presentation, A&E stay and rehabilitation delivery in 117 consecutive stroke patients. The mean presentation delay was 16.0 +/- 23.7 hours. A prior history of TIA or stroke, a reduced Glascow Coma Scale and larger strokes were associated with shorter delays to presentation. Longer delays occurred in patients living alone. The mean time spent in A&E was 11 hours, those with larger strokes spent shorter time. There were significant delays in referral to, and assessment by certain rehabilitation disciplines. Delayed presentation in stroke is a barrier to thrombolysis. Increasing public awareness may reduce this delay. In addition, prolonged A&E stay and delayed rehabilitation may adversely affect management, outcome and duration of hospital stay. Further study is required to investigate the reasons and possible solutions for such deficiencies.
authors.affiliation: Department of Neurology, Beaumont Hospital, Dublin 9, Ireland. pittock.sean@mayo.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Pittock
authors.forename: D
authors.initials: D
authors.lastname: Meldrum
authors.forename: O
authors.initials: O
authors.lastname: Hardiman
authors.forename: C
authors.initials: C
authors.lastname: Deane
authors.forename: P
authors.initials: P
authors.lastname: Dunne
authors.forename: A
authors.initials: A
authors.lastname: Hussey
authors.forename: M
authors.initials: M
authors.lastname: Gorman
authors.forename: J T
authors.initials: JT
authors.lastname: Moroney
mesh_terms: D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007494:Ireland; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D000071939:Stroke Rehabilitation; D015912:Thrombolytic Therapy; D013997:Time Factors