title: The time interval window between stroke onset and hospitalization and its related factors.
abstract: OBJECTIVE
  Successful acute stroke intervention depends on early hospitalization. The time interval between stroke onset to hospitalization was examined to identify the factors influencing the interval and also to determine whether treatment time window expansion will translate into more treatment.
  
  
  METHODS
  Data was obtained from Takashima Stroke Registry covering approximately 55,000 residents in Japan. During 1988-2002, the interval between stroke onset and hospitalization was available for 1,446 registered patients (men 761, women 685). Multivariate regression analyses were performed to evaluate the factors influencing early and late admission.
  
  
  RESULTS
  The proportions of the patients who arrived within 3 h of onset were 61.4%. Only 8.7% of the patients arrived during a 3- to 6-hour interval. A substantial proportion (29.9%) of patients arrived after 6 h. Early stroke hospitalization was significantly associated with the severity of the stroke event and time of stroke onset.
  
  
  CONCLUSIONS
  Clinically more severe stroke patients were hospitalized earlier and nocturnal strokes had delayed admission. Even expanding the therapeutic time window from </=3 to </=6 h, there are possibilities that a substantial proportion of patients would not benefit from acute intervention. Future research should focus not only on developing therapies for expanding the treatment time window, but also place emphasis on reducing the interval between onset and hospitalization.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan. turin@belle.shiga-med.ac.jp
authors.forename: Tanvir Chowdhury
authors.initials: TC
authors.lastname: Turin
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.forename: Nahid
authors.initials: N
authors.lastname: Rumana
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Takashima
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Sugihara
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Morita
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000592:standards; D012042:Registries / Q000592:standards; D020521:Stroke / Q000453:epidemiology* / Q000628:therapy*; D013997:Time Factors; D014187:Transportation of Patients / Q000592:standards