Stroke, Vol 23, 835-838, Copyright © 1992 by American Heart Association
GD Harper, RA Haigh, JF Potter and CM Castleden
BACKGROUND AND PURPOSE: Use of thrombolysis and acute treatments for
cerebral infarction may require that acute stroke be treated as a medical
emergency. To assess the factors influencing the time to admission in acute
stroke, we conducted a prospective study of all such patients admitted to
the hospitals in Leicester, UK, over a 12-month period. METHODS: Factors
assessed were age, sex, time of stroke onset, stroke severity, home
circumstances, and routes of admission. Initial between-group comparisons
were made with the Mann-Whitney U test. The individual contribution of each
of these variables was assessed with multiple linear regression analysis.
RESULTS: An accurate time of stroke onset was identified in 374 (70%) of
535 registered patients (median age 77 [range, 29-98] years; 332 men, 203
women). Median time from onset to admission was 6 hours, with 25% of the
patients arriving in less than 2.5 hours and 75% in less than 11.5 hours.
Multiple regression confirmed that only admission through the bed
allocation bureau (p less than 0.001), living alone (p less than 0.001),
and nocturnal onset (p = 0.003) prolonged delay time. Despite patients over
70 years of age taking a median of 7 hours from onset to admission compared
with 4 hours for those under age 70 (p less than 0.001), the effect of age
appeared to be dependent on these three factors. Age, sex, level of
consciousness, rural domicile, and place of admission did not influence the
delay time independently. CONCLUSIONS: We have identified some of the
factors affecting the hospital admission delay time for stroke. With the
possible advent of effective early treatments for stroke, these factors
will need to be addressed.
ARTICLES
Factors delaying hospital admission after stroke in Leicestershire
University Department of Medicine for the Elderly, Leicester General Hospital, UK.
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