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首页> 美国卫生研究院文献>Journal of Clinical Medicine >Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
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Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke

机译：急性缺血性卒中患者院前延迟缩短的相关因素

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Background: Despite recent advances in acute stroke care, only 1–8% of patients can receive reperfusion therapies, mainly because of prehospital delay (PHD). Objective: This study aimed to identify factors associated with PHD from the onset of acute stroke symptoms until arrival at the hospital. Methods: A cross-sectional study was conducted including all patients consecutively admitted with stroke symptoms to Burgos University Hospital (Burgos, Spain). Socio-demographic, clinical, behavioral, cognitive, and contextualized characteristics were recorded, and their possible associations with PHD were studied using univariate and multivariable regression analyses. Results: The median PHD of 322 patients was 138.50 min. The following factors decreased the PHD and time until reperfusion treatment where applicable: asking for help immediately after the onset of symptoms (OR 10.36; 95% confidence interval (CI) 4.47–23.99), onset of stroke during the daytime (OR 7.73; 95% CI 3.09–19.34) and the weekend (OR 2.64; 95% CI 1.19–5.85), occurrence of stroke outside the home (OR 7.09; 95% CI 1.97–25.55), using a prenotification system (OR 6.46; 95% CI 1.71–8.39), patient’s perception of being unable to control symptoms without assistance (OR 5.14; 95% CI 2.60–10.16), previous knowledge of stroke as a medical emergency (OR 3.20; 95% CI 1.38–7.40), call to emergency medical services as the first medical contact (OR 2.77; 95% CI 1.32–5.88), speech/language difficulties experienced by the patient (OR 2.21; 95% CI 1.16–4.36), and the identification of stroke symptoms by the patient (OR 1.98; 95% CI 1.03–3.82). Conclusions: The interval between the onset of symptoms and arrival at the hospital depends on certain contextual, cognitive, and behavioral factors, all of which should be considered when planning future public awareness campaigns.
机译：背景：尽管最近在急性中风护理方面取得了进步，但主要由于院前延误（PHD），只有1–8％的患者可以接受再灌注疗法。目的：本研究旨在确定从急性中风症状发作到住院期间与PHD相关的因素。方法：进行了一项横断面研究，纳入了所有连续入院并患有中风症状的患者，并进入了布尔戈斯大学医院（西班牙布尔戈斯）。记录了社会人口统计学，临床，行为，认知和情境特征，并使用单变量和多变量回归分析研究了它们与PHD的可能关联。结果：322名患者的中位PHD为138.50分钟。以下因素减少了PHD和直到适用时再灌注治疗的时间：症状发作后立即寻求帮助（OR 10.36； 95％置信区间（CI）4.47-23.99），白天中风发作（OR 7.73； 95） ％CI 3.09–19.34）和周末（OR 2.64； 95％CI 1.19–5.85），在家中发生中风（OR 7.09； 95％CI 1.97–25.55），使用预先通知系统（OR 6.46； 95％CI 1.71–8.39），患者感觉没有帮助就无法控制症状的感觉（OR 5.14； 95％CI 2.60–10.16），先前对中风的紧急医疗知识（OR 3.20； 95％CI 1.38–7.40），紧急呼叫首次就医（OR 2.77; 95％CI 1.32–5.88），患者遇到的言语/语言障碍（OR 2.21; 95％CI 1.16–4.36）以及患者对中风症状的识别（OR 1.98； 95％CI 1.03–3.82）。结论：症状发作与到达医院之间的时间间隔取决于某些背景，认知和行为因素，在计划未来的公众意识运动时应考虑所有这些因素。

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