Factors associated with prehospital delay for acute stroke in Ulsan, Korea.
BACKGROUND
Early hospital presentation is critical in the treatment of acute ischemic stroke with thrombolysis.


OBJECTIVE
The aim of this study was to investigate the factors associated with prehospital delay in acute ischemic stroke.


METHODS
Data were retrospectively collected over a 1-year period from 247 acute ischemic stroke patients who presented to the emergency department (ED) within 7 days after symptom onset. To investigate the factors associated with prehospital delay, sociodemographic data, initial symptoms, risk factor, National Institutes of Stroke Scale in the ED, and use of emergency medical services (EMS) were evaluated. Univariate and multivariate analysis were used to evaluate delay factors.


RESULTS
Of 247 patients (mean age 64.4 ± 12.6 years, 149 male patients), the non-delay group (≤ 2 h after symptom onset) included 45 patients (mean age 60.0 ± 13.1 years, 31 male patients) and the delay group (> 2 h after symptom onset) included 202 patients (mean age 65.4 ± 12.3 years, 118 male patients). Advanced age (odds ratio [OR] 1.056, 95% confidence interval [CI] 1.024-1.089), no consciousness disturbance at symptom onset (OR 2.938, 95% CI 1.066-8.104), presentation to ED by self (OR 3.826, 95% CI 1.580-9.624), referral from other hospital (OR 16.787, 95% CI 5.445-51.750), and worsened symptoms at the ED compared to symptom onset (OR 7.708, 95% CI 1.557-38.151) were associated with a prehospital delay.


CONCLUSIONS
Elderly patients with progressive symptom worsening had delayed arrival, but those who used EMS or had disturbed consciousness at symptom onset had early arrival.
Kim
Hyung Ju
HJ
Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ahn
Jung Hwan
JH
Kim
Sun Hyu
SH
Hong
Eun Seog
ES
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D004632:Emergency Medical Services / Q000592:standards; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000628:therapy; D013997:Time Factors