Factors Investigate Influencing Pre-hospital And In-hospital Delay After Acute Ischemic Stroke

Objective This study intend to explore the delayed situation of diagnosis and treatmenton the patient with acute ischemic stroke in Yinchuan and it’s surrounding areas and toanalyze the relevant factors leading to delays. Provide an objective basis for thedevelopment of practical interventions.Methods We collected a total of231patients with acute ischemic stroke from July1to November30in2011.These cases came from the Department of Neurology and the StrokeUnit, General Hospital of Ningxia Medical University, Cardiovascular and CerebrovascularHospital of Ningxia Medical University. The object included demographic sociologicalinformation, medical history, personal and family history, the onset situation, treatmentprocess etc. Patients were divided into treatment delay group and treatment in time groupaccording to whether arrived to hospital within3hours or not. Statistical analysis includedused t/χ~2/wilcoxon rank test and logistic model to analyze the collected data, P＜0.05(statistically significant).Results The average pre-hospital delay time among231patients is63.5hours; themedian times are45.0hours. In-hospital delay average time are3.71hours; the median timesare3.0hours．The factor associated with a delay in reaching the hospital was including Sex,place of residence, career, medical insurance, previous history of stroke, the onset mode,distance between stroke onset site to hospital, whether with disorders of consciousness onset，first hospital arrived, the way to hospital, arriving hospital by ambulance or not, the NIHSSscore of admission, whether patients know the knowledge of stroke etc. Logistic regressionshowed the following factors were independently related to hospitalization delay: not selecting our hospital first, not by ambulance, long distance between the site where strokeonset occurred and hospital, peoples in job. While high NIHSS score and history of stroke arehelpful to avoid hospitalization delay．Conclusion The phenomena of admission delay in ischemic stroke is especially seriousin Yinchuan and it’s surrounding areas and there is a low treatment rate of thrombolytictherapy．The public lack of awareness of stroke-related knowledge and can not be correctunderstanding of stroke Symptom. Treatment procedures are not standardized and all therelated departments does not cooperate closely.Thus to raise awareness public education anduse of the emergency are necessary of early care of acute stroke, to perfect green channel andunderstand and evaluate the pros and cons of thrombolytic are crucial.