title: Factors delaying hospital arrival of patients with acute stroke.
abstract: BACKGROUND
  To determine the proportion of patients with acute stroke presenting late to hospital and to identify the factors that delay hospital arrival of patients with acute stroke.
  
  
  METHODS
  A cross sectional study was carried out between Sept 2006 to Feb 2007 in the department of Neurology, Liaquat National Hospital Karachi. All patients of both genders, ago >18 years with symptoms of stroke and neuro- imaging (CT scan/MRI brain) findings consistent with stroke were included.
  
  
  RESULTS
  Atotal of 165 patients attending the Emergency department were included. There were 86 (52%) males and 79 (47.9%) females. The mean age was 60.04+/-13.98 years, (males 58.2 years and females 61.9 years). The median delay from onset of symptoms to hospital arrival was six hours. Only 28.5% of the patients came within three hours while 71.5% after three hours. Attendants of 47 patients had a low throat perception, 53 (32%) of the patients did not know a single symptom of stroke and 63% (104) patients first contacted their General Practitioner who referred them to hospital. Similarly 60.6% of patients wore first taken to a local hospital not equipped to handle major emergencies.
  
  
  CONCLUSIONS
  Time elapsed from onset of symptoms to hospital arrival is influenced by lack of knowledge of stroke symptoms, contact with a local doctor, low threat perception and non availability of ambulance services.
authors.affiliation: Department of Neurology, Liaquat National Hospital, Karachi.
authors.forename: Maimoona
authors.initials: M
authors.lastname: Siddiqui
authors.forename: Shoaib Rasheed
authors.initials: SR
authors.lastname: Siddiqui
authors.forename: Azra
authors.initials: A
authors.lastname: Zafar
authors.forename: Farrukh Shohab
authors.initials: FS
authors.lastname: Khan
mesh_terms: D000208:Acute Disease; D000553:Ambulatory Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000600:supply & distribution*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D020521:Stroke / Q000628:therapy*; D013997:Time Factors