An Analysis of the Admission Delay of Acute Strokes

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Abstract
The main factors influencing admission delay of stroke patients were investigated in 309 consecutive cases admitted to the emergency room of a University hospital. All these patients were examined and interviewed by a neurologist. Forty-two percent (117 patients) arrived within 6 h of the onset of symptoms. Extrahospital delay accounted for the largest fraction of time lost (82%), followed by intrahospital delay (16%) and transportation (2%). A medical contact prior to our hospital significantly delayed admission (mean delay 35 vs. 23 h, t = 1.82, p = 0.03). The percentage of strokes arriving within 6 h was higher (χ2 = 5.8, p = 0.05), for those whose stroke started during ''working hours'' (09.00-18.00). Age and type of stroke (ischemic or hemorrhagic) did not have a significant influence on admission delay. Hoping that symptoms would clear, nonrecognition of stroke, refusal to go to the hospital, living alone and waiting for relatives were the most common alleged reason for not coming sooner. These results stress the need for educational intervention both for the public and the health professionals, focusing on urgent and direct referral of acute strokes to the hospital.

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