Factors in early hospital arrival following suspected acute stroke symptoms

Han, Dong Hyeob; Shin, Jonghwan; Jung, Jin Hee; Song, Kyoung Jun; Lee, Hui Jai; You, Kyoung Min

J Korean Soc Emerg Med > Volume 33(5); 2022 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2022;33(5): 436-447.

Factors in early hospital arrival following suspected acute stroke symptoms

¹Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
²Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea

Correspondence

Jonghwan Shin ,Tel: 02-870-2826, Fax: 02-870-2662, Email: skyshiner@naver.com,

Received: October 12, 2021; Revised: October 24, 2021 Accepted: October 28, 2021. Published online: October 31, 2022.

ABSTRACT

Objective:
We investigated the factors that affect the time from the onset of acute stroke symptoms to arrival at the emergency department (ED).
Method:
Between July 2019 and February 2020, patients with acute stroke symptoms who visited a public hospital were evaluated by retrospective analysis using a prospective survey. The data for this study was gathered from baseline interviews with patients enrolled in stroke surveys. The primary outcome was time to arrival at the ED, evaluated as a binary variable with a value of 4.5 hours.
Results:
Overall, 205 patients were included in the final analysis. Among them, 47% (n=96) of patients with acute stroke symptoms arrived at the ED later than 4.5 hours from the time of onset of acute stroke symptoms. After multivariable logistic regression analyses, it was found that patients with higher National Institutes of Health Stroke Scale (NIHSS) scores, patients who did not live with their family members, and patients who were found by a passerby were associated with early ED arrival post onset of acute stroke symptoms. Among patients diagnosed with acute stroke, those with higher NIHSS scores or underlying malignant diseases were found to present earlier at the ED.
Conclusion:
Approximately half of the patients (47%) with acute stroke symptoms presented to the ED within 4.5 hours. Higher NIHSS scores and the presence of underlying malignancy were identified as the key factors that were associated with an early presentation at the ED from the time of onset of acute stroke.

Key words: Stroke; Emergency department; Interview