Abstract WP178: Social Factors Causing Delay Of Hospital Visit In Stroke Patients
Objective: Stroke should be treated immediately after the onset; however, a variety of factors cause delay of hospital visit. Here we examined this issue focusing on the social factors.
Materials and Methods: A consecutive series of 469 patients was collected prospectively between May 2007 and March 2009. All patients were admitted within 2 weeks after the onset of stroke. Median age of patients was 75 years old.
Results: Median time between the onset of stroke and hospital visit (“delay”) was 12.7 hours, ranging from 0.1 to 333.6. Ninety-two patients (20%) lived alone and 377 patients lived with their family or stayed at nursery homes. There was no significant difference in “delay” among them (p=0.41). The “delay” was further analyzed according to the styles of living together in 377 patients. Living with spouse caused a significant delay in hospital visit comparing to living at nursery homes (p=0.0001) and to living with their children (p=0.004), respectively. Living styles was categorized in 3 patterns; i.e., living alone (“alone”), living with spouse (“spouse”), and others (“others”). Median “delay” was 14.8 hours in “alone”, 18.9 hours in “spouse”, and 8.25 hours in “others”, respectively. There was a significant difference between “alone” and “others” (p=0.018), and between “spouse” and “others” (p<0.0001), respectively. Knowledge of rt-PA and use of ambulance cars significantly caused an earlier visit to the hospital (p=0.0006 and p<0.0001, respectively). On the other hand, consultation to family doctors, even by telephone, caused a significant delay of hospital visit (p<0.0001). Two hundred and eighty-eight patients recognized the symptoms by themselves and it was also a significant factor for the delay of hospital visit (p<0.0001). The after-hours onset of stroke was not a causative factor for the delay of hospital visit.
Conclusions: Both living with spouse and living alone were risk factors for the delay of hospital visit. Knowledge of rt-PA, use of ambulance cars caused early hospital visit. Consultation to family doctors, even by telephone, and recognition of symptoms by patients themselves caused delay of hospital visit. The after-hours onset of stroke did not affect “delay”. The enlightenment to the general public is required.
- © 2012 by American Heart Association, Inc.