Investigation And Study On Hospitalization Delay And Associated Factors Of Stroke Patient

Objective:To study the admission condition of stroke patients in Da lian Friends Hospital and analyse the associated factors of hospitalization delay.Method: Verified questionnaires were used to investigate all of the 179 stroke patients in hospital from Oct,2007 to March,2008.The questionnaires include : personal history ,past history, living pattern , family history ,the condition of stroke onset, the reason for no thrombolysis, whether to see doctor , whether to master health knowledge. The patients were divided into two groups according to prehospital time within or after 6 hours. The datas were inputed data-bank. Statistical analysis included t-test,χ~2-test , logistic regression.Results:The average prehospital time among 179 patients is 26.2h .The median number is 7.5h . There is great difference between the hemorrhagic stroke (2.0h) and ischemic stroke (12h).The number of hemrrlagic stroke in within-6hs group is greater than that in after-6hs group . When it comes to the ischemic stroke, the situation is contrary . There are great difference between the within-6hs group and the after-6hs group, including previous cardiac disease , distance between stroke onset site to hospital , whether with convulsion or disorders of consciousness onset , weather to emergency room directly, arriving hospital by ambulance or not , time on ambulance between stroke onset site to hospital, time for CT and MRI scan, whether patients know treatment was immediately needed the onset of stroke, whether patients know alcohol is a risk factor for stroke , the Glasgow Scale Score is low . However, there are no difference on these factors including: age, sex, nation, marriage, career, education level , economic level, medical insurance , family history of stroke., previous history ,whether to smoke or drink, the time for stroke, the way to hospital ,the time to emergercy room and outpatient room . time for examination, whether to know the stroke onset and to know thrombolysis, the other risk factors of stroke , neurological impartment scale score . Among 147 stroke patients , 64 patients did not receive thrombolysis therapy because of the prehospitial time . Logistic regression showed the following factors were related to hospitalization delay : long distance between to the site where stroke onset occurred and hospital, long time in out-patient room . While arring hospital by ambulance is helpful to avoid hospitalization delay .Conclusion : The phenomena of admission delay is especially common in my hospital and there is a low treatment rate of thrombolysis therapy in ischemic stroke . Thus , it demonstrates that admission condition is not optimistical among stroke patients in Dalian Friendship Hospital . The main reason of admission delay lies in not knowing relevant risk factors and clinic symptoms of stroke ,not knowing the treatment principle thrombolysis and therapatic time and not completely using emergence system . So to encourage patients to accept health education about stroke , to enhancemedical personnel's continual education , to strengthen emergence awareness , to call for 120 after illness happened , to build green gate for stroke patients and to establish stroke unit in order to solve delay treatment are the keys.