[Factors associated with delayed hospital treatment for patients with acute cerebrovascular disease].
BACKGROUND
Cerebrovascular diseases are an important cause of morbidity and mortality in the world and the effectiveness of thrombolytic therapy depends on early intervention.


OBJECTIVE
To determine the time taken for patients with acute cerebrovascular events to reach hospital and to observe the variables associated to a longer delay.


METHODS
We conducted a retrospective, descriptive study of 151 patients treated for acute cerebrovascular events between September 2003 and September 2004 at the Hospital Nacional Cayetano Heredia (Lima, Peru). We searched the records for the time taken to reach hospital, demographic variables and cerebrovascular risk factors, and we observed whether they exerted a significant effect on the arrival time.


RESULTS
It was found that 29.8% of patients with an acute cerebrovascular event go to hospital within the first three hours; the mean arrival time is 51.11 hours. In contrast, 51% of patients go to hospital after more than 12 hours. Taking three and six hours as the cut-off points, uni and multivariate analyses showed ischemic stroke to be linked to a longer delay; a diagnosis of atrial fibrillation is associated to a shorter delay in arrival time in the multivariate analysis if a cut-off time of three hours is taken into account.


CONCLUSIONS
Despite the high percentage of patients who take a long time to visit hospital following a cerebrovascular event, approximately a third of the patients would benefit from early treatment with thrombolytic therapy.
Kawano-Castillo
J
J
Hypnos Instituto del Sueño, Clínica San Felipe, Lima, Perú. hypnos@clinicasanfelipe.com
Chuquilín-Arista
M
M
Tipismana-Barbarán
M
M
Vizcarra-Escobar
D
D
D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000628:therapy*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010568:Peru; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D013997:Time Factors; D014187:Transportation of Patients