Analysis On The Factors And Prognosis Of Delayed Admission For Acute Stroke In Qinghai Area

Objective:To analyze the related influencing factors of delayed visit for patients with acute stroke and the difference of prognosis between early visit and delayed visit in Qinghai area,and to propose improved method for related factors to improve the rate of early visit for acute stroke in Qinghai area.Methods: Patients with acute stroke who was treated in the department of neurology of Qinghai Provincial People's Hospital from October 2017 to August 2018 were selected.Accomplish the NIHSS score,BI scale when patients were admitted to hospital,delay in seeking medical care factors questionnaire was finished in 1-3 days,which including general demographic information,Status at the time of onset,treatment at onset,past medical history,family history,whether aware of stroke,whether to know for stroke high-risk population,etc.NIHSS score and BI score were performed again at the 10 th and 6th months of follow-up.According to whether the admission time was within 6 hours of the onset,the patients were divided into the early treatment group and the delayed treatment group,the relevant influencing factors and prognosis of the two groups were compared,and the relevant data were analyzed.Results: Total of 477 patients,including 366 cases of ischemic stroke(76.73%)and 111 cases of hemorrhagic stroke(23.27%).The average visit time for acu-te stroke patients in Qinghai was(40.90±61.40)h,with a median of 11 h,theoverall mean age(64.13±12.58)years old,293 males and 184 females.Single factor analysis found that cerebral stroke type,former state,distance from hosp-ital,measures taken after onset,the way to the hospital,limb numbness,devi-ated mouth,disturbance of speech,disturbance of consciousness,first symptom ? 3,whether aware of stroke,whether to know for stroke high-risk population difference between stroke early treatment group and the delayed treatment group have statistical difference(P<0.05).Logistic regression analysis was performed on possible influencing factors of delayed visit,and the results showed: distance from hospital(OR=2.013),the first symptom without disturbance of consciousness(OR=2.134)is an independent risk factor for delayed treatment of acute stroke in Qinghai area.Hemorrhagic stroke(OR=0.293),dial 120 emergencycall(OR=0.078),admission through120 ambulance(OR=0.153),awareness of stroke(OR=0.137),and known as the high-risk group of stroke(OR=0.079)which may be more timely.The difference in NIHSS score,BI score between the two groups on admission for 10 days was significant statistically(P<0.05),and the difference in NIHSS score,BI score between admission and 6-month follow-up was significant statistically(P<0.05).Conclusion: 1.Patients with acute stroke in Qinghai area far away from the hospital,the first symptom without disturbance of consciousness may be prone to delay in seeking medical treatment.For hemorrhagic stroke,dial 120 emergency calls,admission through 120 ambulances,awareness of stroke,known as high risk of stroke patients may be more timely.2.The degree of neurological function recovery in patients with acute stroke in the early stage may be better than that in patients with delayed diagnosis...