The time interval window between stroke onset and hospitalization and its related factors.
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.
Turin
Tanvir Chowdhury
TC
Department of Health Science, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan. turin@belle.shiga-med.ac.jp
Kita
Yoshikuni
Y
Rumana
Nahid
N
Takashima
Naoyuki
N
Ichikawa
Masaharu
M
Sugihara
Hideki
H
Morita
Yutaka
Y
Miura
Katsuyuki
K
Okayama
Akira
A
Nakamura
Yasuyuki
Y
Ueshima
Hirotsugu
H
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