title: Impact of life and family background on delayed presentation to hospital in acute stroke.
abstract: The over-65 population stands at 29 million, more than 20% of the total population in Japan. This is the highest rate in the world. One-person households and older couple households will be increasing. The aim of the present study was to identify whether life and family background are significant factors for delayed presentation to hospital after stroke onset. A total of 253 patients (mean age, 70.7 ± 13.2 years) with stroke was examined. Patients who presented to hospital within 3 hours of onset were categorized as the early presentation group, and the other patients were categorized as the late presentation group. Life and family background were classified into 3 categories, namely 1-person households, 2-person households, and patients living with 3 or more persons. Two-person households were further subdivided by the age of family members. Multivariate logistic regression analysis demonstrated that 1-person households (odds ratio [OR]: 2.980, 95% confidence interval [CI]: 1.108-8.011) and 2-person households with individuals 65 years and older (OR: 3.059, 95% CI: 1.297-7.217) were significant independent factors for delayed presentation, in addition to stroke subtype, time of stroke onset, and route of admission. Onset-to-door time in patients with night-time onset was significantly different among different types of households. Significant delay was demonstrated in 2-person households with 2 individuals 65 years and older compared with that in patients living with 3 or more persons (P = .038). Our findings show that delayed presentation to hospital is more likely in stroke patients living in an elderly couple household, especially those with evening onset in an aging society.
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan. Electronic address: shinnai@marianna-u.ac.jp.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Hagiwara
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Imai
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Sakurai
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Atsumi
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tsuruoka
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Heisuke
authors.initials: H
authors.lastname: Mizukami
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Naoshi
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Hisanao
authors.initials: H
authors.lastname: Akiyama
authors.affiliation: Division of Neurology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hasegawa
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D005191:Family Characteristics; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000145:classification / Q000453:epidemiology / Q000628:therapy*
keywords: Households; aged society; stroke; thrombolysis