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Factors Associated with Pre-Hospital Delay and Intravenous Thrombolysis in China
- Source :
- Journal of Stroke and Cerebrovascular Diseases. 29:104897
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Pre-hospital delay was a critical factor affecting stroke patients receiving intravenous thrombolytic therapy. The aim of this study was to explore the factors associated with pre-hospital delay and thrombolysis in China. Methods Patient data were obtained from emergency department (ED), and the factors of patient pre-hospital delay were recorded through a well-designed form. Results A total of 630 patients were eventually included in the study. 317 patients were admitted to the ED during the thrombolysis time window, and only 105 patients received intravenous thrombolytic therapy. In the univariate analysis, transportation (OR: 0.15; 95% CI: 0.44 - 0.518; p = 0.001), atrial fibrillation (OR: 0.555; 95% CI: 0.372-0.828; p = 0.004) and response of symptoms (OR: 0.002; 95% CI: 0.000-0.013; p = 0.000) were associated with early arrival. Speech disturbances (OR: 2.095; 95% CI: 1.294-3.391; p = 0.002), smoking (OR: 2.563; 95% CI: 1.527-4.304; p = 0.000), alcohol consumption (OR: 2.155; 95% CI: 1.159-4.005; p = 0.014) and referral presentation (OR: 2.837; 95% CI: 1.584-5.082; p = 0.000) were associated with thrombolysis. In the logistic regression analysis, direct visiting to the hospital after onset and rushing to emergency after onset were independent predictor of early arrival of AIS and intravenous thrombolytic. Conclusions The pre-hospital delay of acute ischemic stroke in China was still serious. Strengthening the ability to identify stroke-related symptoms and establishing a mutual referral medical support service model between lower and upper hospitals may effectively shorten the pre-hospital delay of stroke patients.
- Subjects :
- Male
China
medicine.medical_specialty
Time Factors
Referral
medicine.medical_treatment
Logistic regression
Risk Assessment
Time-to-Treatment
03 medical and health sciences
0302 clinical medicine
Fibrinolytic Agents
Risk Factors
medicine
Humans
Thrombolytic Therapy
Prospective Studies
Acute ischemic stroke
Univariate analysis
business.industry
Rehabilitation
Atrial fibrillation
Thrombolysis
Emergency department
Middle Aged
medicine.disease
Service model
Stroke
Early Diagnosis
Transportation of Patients
Treatment Outcome
Emergency medicine
Administration, Intravenous
Female
Surgery
Neurology (clinical)
Emergency Service, Hospital
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10523057
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Journal of Stroke and Cerebrovascular Diseases
- Accession number :
- edsair.doi.dedup.....64cfa6c2797ae6d3ce564e4428822271