The Investigation of Factors Effecting the Management of Stroke Pations
Özcan Keskin, M. Kalemoğlu, T. Deniz
Gülhane Askeri Tıp Akademisi Haydarpaşa Eğitim Hastanesi Acil Servis
Study objective: Recent studies showed that fibrinolytic treatment in the first three hours after the symptoms onset prevents the cerebral tissue damage. In this study, the factors affecting the dispatch and treatment processes of patients presenting with acute stroke to the emergency department were investigated.
Methods: The patients presented with symptoms related to acute stroke were included into this prospective observational study. The durations of asking for an aid, dispatch, examination in the ED, consultation and takin a tomography were evaluated between the symptoms onset and hospitalizatio period. The patients were classified into three groups according to their intervention periods. These groups are classified like this: group I <120 minutes, group II is between120-300 minutes and group III >301 minutes The patients presenting to the ED 6 hours after the symptoms onset were excluded from the study.
Results: 229 patients presented with stroke were included to the study. Study subjects had a mean age of 71±19 and 39.3%were women. The prolonged period of asking for a medical aid was the most important reaso of delay in the management of stroke patients. Meanwhile, the arriving tim of consultants to the ED was another factor contributing to the delay. The factors determining the prolonged period of asking for a medical aid were the social and cultural features of patients, co morbid disease, to be unawareness of the symptoms (coma or altered mental status), symptoms begin during the night, history of a previous stroke and to have a low strok score.
Conclusion: To accelerate the management time of stroke patients, the delays in asking for a medical aid after the symptoms onset should be prevented. The risky patients and their family or attendants should be educated in recognizing a stroke to prevent these delays.