Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke
Abstract
:1. Introduction
2. Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Socio-Demographic Factors | n (%) | PHD, Minutes | p-Value |
---|---|---|---|
Median (IQR) | |||
Age: | |||
≤75 | 118 (36.65) | 126 (73–272) | 0.334 |
>75 | 204 (63.35) | 148 (75–356) | |
Sex: | |||
Male | 181 (56.21) | 133 (79–293) | 0.839 |
Female | 141 (43.79) | 152 (65–359) | |
Marital status: | |||
Married | 146 (45.34) | 132.5 (84–272) | 0.804 |
Not married at the moment | 176 (54.66) | 150 (70–344) | |
Educational level: | |||
No or primary study | 211 (65.53) | 142 (75–327) | 0.819 |
Secondary or higher study | 111 (34.47) | 129 (72–335) | |
Average annual income: | |||
≤€20.000 | 239 (74.22) | 140 (75–327) | 0.753 |
>€20.000 | 83 (25.78) | 128 (70–335) | |
Living arrangements: | |||
Alone | 70 (21.74) | 190 (64–401) | 0.511 |
With others | 252 (78.26) | 133 (75–299) |
Clinical Factors | n (%) | PHD, Minutes | p-Value |
---|---|---|---|
Median (IQR) | |||
Arterial hypertension | |||
Yes | 225 (69.88) | 139 (75–332) | 0.754 |
No | 97 (30.12) | 136 (73–305) | |
Diabetes mellitus | |||
Yes | 80 (24.84) | 129.5 (70–310) | 0.904 |
No | 242 (75.16) | 139 (74–335) | |
Dyslipidemia | |||
Yes | 158 (49.07) | 129 (84–359) | 0.754 |
No | 164 (50.93) | 151 (69–299) | |
Overweight/obesity | |||
Yes | 214 (66.46) | 132.5 (75–327) | 0.817 |
No | 108 (33.54) | 168 (70–333) | |
Cardiovascular disease | |||
Yes | 159 (49.38) | 138 (75–359) | 0.937 |
No | 163 (50.62) | 142 (74–309) | |
Atrial fibrillation | |||
Yes | 101 (31.37) | 130 (69–374) | 0.387 |
No | 221 (68.63) | 150 (80–305) | |
Previous stroke | |||
Yes | 73 (22.67) | 115 (65–245) | 0.078 |
No | 249 (77.33) | 146 (79–356) | |
Family history of stroke | |||
Yes | 114 (35.40) | 148 (85–350) | 0.210 |
No | 208 (64.60) | 132.5 (70–322) | |
Active smoker | |||
Yes | 52 (16.15) | 130.5 (72–393) | 0.864 |
No | 270 (83.85) | 140 (75–311) | |
Alcohol consumption | |||
Yes | 147 (45.65) | 136 (80–335) | 0.702 |
No | 175 (54.35) | 140 (70–294) | |
Physical activity | |||
>3 days per week | 148 (45,96) | 136 (78–335) | 0.648 |
<3 days per week | 174 (54,04) | 139 (71–295) | |
Motor symptoms | |||
Yes | 215 (66.77) | 129 (67–294) | 0.151 |
No | 107 (33.23) | 156 (95–336) | |
Sensitive symptoms | |||
Yes | 37 (11.49) | 133 (68–399) | 0.718 |
No | 285 (88.51) | 139 (75–314) | |
Speech/language disturbance | |||
Yes | 207 (64.29) | 120 (67–249) | 0.001 |
No | 115 (35.71) | 197 (92–411) | |
Alteration of consciousness | |||
Yes | 37 (11.49) | 167 (74–342) | 0.533 |
No | 285 (88.51) | 133 (74–323) | |
Alteration of vision | |||
Yes | 31 (9.63) | 118 (61–286) | 0.319 |
No | 291 (90.37) | 139 (75–335) | |
Dizziness/instability | |||
Yes | 72 (22.36) | 134.5 (83–435) | 0.182 |
No | 250 (77.64) | 139.5 (69–281) | |
Headache | |||
Yes | 41 (12.73) | 170 (102–486) | 0.035 |
No | 281 (87.27) | 133 (70–297) | |
Previous similar symptoms | |||
Yes | 82 (25,47) | 125.5 (65–628) | 0.200 |
No | 240 (74.53) | 145 (78–345) | |
Onset mode of symptoms | |||
Gradual/stepwise | 36 (11.19) | 190.5 (104–381) | 0.083 |
Sudden | 286 (88.81) | 133.5 (16–718) | |
Type of stroke | |||
Ischemic | 278 (86.34) | 135 (73–328) | 0.513 |
Hemorrhagic | 44 (13.66) | 158.5 (84–360) | |
Affected cerebral hemisphere | |||
Right | 121 (37.58) | 144 (71–331) | 0.921 |
Left | 182 (56.52) | 133 (75–333) | |
Bilateral | 19 (5.90) | 184 (75–286) | |
Stroke severity | |||
NIHSS ≤ 16 | 267 (82.92) | 144 (74–335) | 0.446 |
NIHSS > 16 | 55 (17.08) | 111 (75–272) | |
Previous level of dependence | |||
mRS > 2 | 246 (76.40) | 141 (74–328) | 0.826 |
mRS ≤ 2 | 76 (23.60) | 135.5 (72–342) |
Behavioral Factors | n (%) | PHD, Minutes | p-Value |
---|---|---|---|
Median (IQR) | |||
Type of coping | |||
Active | 123 (38.20) | 140 (75–273) | 0.651 |
Passive | 199 (61.80) | 136 (72–359) | |
First response after onset of symptoms: | |||
Asked for help | 188 (58.39) | 91.5 (56–135) | <0.001 |
Did not ask for help | 134 (41.61) | 289.5 (198–458) | |
First medical contact | |||
EMS | 143 (44.41) | 106 (58–232) | <0.001 |
PCP | 92 (28.57) | 198 (110–382) | |
Hospital | 87 (27.02) | 150 (72–397) | |
Previous use of EMS: | 0.714 | ||
Yes | 186 (57.76) | 132.5 (70–335) | |
No | 136 (42.24) | 141 (80–307) |
Cognitive Factors | n (%) | PHD, Minutes | p-Value |
---|---|---|---|
Median (IQR) | |||
Symptoms attributed: | |||
Possibly stroke | 82 (25.47) | 95.5 (55–138) | <0.001 |
Possibly not stroke | 240 (74.53) | 195.5 (91–389) | |
Self-perceived level of seriousness: | |||
Not serious (1–3) | 259 (80.43) | 169 (85–376) | <0.001 |
Serious (4–5) | 63 (19.57) | 98 (53–152) | |
Anxiety level: | |||
Low (1–3) | 216 (67.07) | 185 (83–389) | <0.001 |
High (4–5) | 106 (32.93) | 108 (65–193) | |
Thought, the situation could be self-managed: | |||
Yes | 80 (24.85) | 359 (247–537) | <0.001 |
No | 242 (75.15) | 106 (63–195) | |
Thought, symptoms would improve: | |||
Yes | 95 (29.50) | 329 (193–485) | <0.001 |
No | 227 (70.50) | 106 (63–199) | |
Previous knowledge of stroke: | |||
Yes | 179 (55.59) | 125 (71–265) | 0.009 |
No | 143 (44.41) | 184 (84–425) | |
Previous knowledge of stroke risk factors: | |||
Yes | 168 (52.17) | 125 (67–266) | 0.011 |
No | 154 (47.83) | 184 (86–401) | |
Previous knowledge of acting after a stroke: | |||
Yes | 112 (34.78) | 76 (50–151) | <0.001 |
No | 210 (65.22) | 196.5 (106–421) |
Contextual Factors | n (%) | PHD, Minutes | p-Value |
---|---|---|---|
Median (IQR) | |||
Person who recognized symptoms: | |||
Patient | 204 (63.35) | 128 (71–296) | 0.057 |
Witness | 118 (36.65) | 180 (83–397) | |
Person who requested assistance: | |||
Patient | 175 (54.35) | 150 (75–376) | 0.140 |
Witness | 147 (45.65) | 125 (71–267) | |
Situation in which found: | |||
Alone | 88 (27.33) | 257.5 (117–446) | <0.001 |
Accompanied | 234 (72.67) | 115 (65–250) | |
Time of day: | |||
Morning (06:00–14:00) | 152 (47.20) | 146.5 (72–335) | <0.001 |
Afternoon (14:00–22:00) | 122 (37.89) | 110 (65–210) | |
Night (22:00–08:00) | 48 (14.91) | 289 (112–650) | |
Type of day: | |||
Working day | 219 (68.01) | 142 (80–390) | 0.093 |
Weekend | 103 (31.99) | 132 (67–251) | |
Onset of symptoms at: | |||
Home | 244 (75.76) | 184 (91–396) | <0.001 |
Other localization | 78 (24.24) | 92.5 (55–104) | |
Area: | |||
Urban | 191 (59.32) | 116 (56–359) | 0.005 |
Rural | 131 (40.68) | 152 (105–309) | |
Mode of arrival: | |||
Ambulance | 221 (68.63) | 128 (71–268) | 0.046 |
Others | 101 (31.37) | 184 (86–404) | |
Prehospital stroke code activated | |||
Yes | 84 (26.09) | 87 (58–135) | <0.001 |
No | 238 (73.91) | 196.5 (95–400) |
Factors | PHD ≤ 210 min | PHD ≤ 360 min | ||
---|---|---|---|---|
ORa (95% CI) | p-Value | OR (95% CI) | p-Value | |
Speech/language disturbance: Yes | 2.21 (1.16–4.36) | 0.023 | - | - |
First response after onset of symptoms: Asked for help | 10.36 (4.47–23.99) | <0.001 | - | - |
Symptoms attributed: Possibly stroke | - | - | 1.98 (1.03–3.82) | 0.041 |
Thought the situation could be self-managed: No | 4.14 (1.70-10.07) | 0.002 | 5.14 (2.60–10.16) | <0.001 |
Previous knowledge of acting after a stroke: Yes | - | - | 3.20 (1.38–7.40) | 0.007 |
Time of day: Day (08:00–22:00) | 7.73 (3.09–19.34) | <0.001 | 3.79 (1.71–8.39) | 0.001 |
Type of day: Weekend | - | 2.64 (1.19–5.85) | 0.017 | |
Onset of symptoms at home: No | 3.03 (1.22–7.55) | 0.017 | 7.09 (1.97–25.55) | 0.003 |
First medical contact: EMS | 2.77 (1.32–5.88) | 0.008 | - | |
Prehospital stroke code activated: Yes | 4.54 (1.77–11.64) | 0.002 | 6.46 (1.71–24.42) | 0.006 |
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Soto-Cámara, R.; González-Santos, J.; González-Bernal, J.; Martín-Santidrian, A.; Cubo, E.; Trejo-Gabriel-Galán, J.M. Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke. J. Clin. Med. 2019, 8, 1712. https://doi.org/10.3390/jcm8101712
Soto-Cámara R, González-Santos J, González-Bernal J, Martín-Santidrian A, Cubo E, Trejo-Gabriel-Galán JM. Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke. Journal of Clinical Medicine. 2019; 8(10):1712. https://doi.org/10.3390/jcm8101712
Chicago/Turabian StyleSoto-Cámara, Raúl, Josefa González-Santos, Jerónimo González-Bernal, Asunción Martín-Santidrian, Esther Cubo, and José M Trejo-Gabriel-Galán. 2019. "Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke" Journal of Clinical Medicine 8, no. 10: 1712. https://doi.org/10.3390/jcm8101712
APA StyleSoto-Cámara, R., González-Santos, J., González-Bernal, J., Martín-Santidrian, A., Cubo, E., & Trejo-Gabriel-Galán, J. M. (2019). Factors Associated with Shortening of Prehospital Delay among Patients with Acute Ischemic Stroke. Journal of Clinical Medicine, 8(10), 1712. https://doi.org/10.3390/jcm8101712