Characteristics of patients who present to the emergency department with sroke and the impact of delayed presentation on therapeutic management strategies

Abstract

Objectives: Stroke is defined as sudden loss of brain function due to distruption of blood şow either by ischemic or hemorrhagic mechanims. Materials and Methods: We aimed to evaluate the demographic properties of patients with the diagnosis of stroke and to measure the time interval from the beginning of complaints to presentation to the emergency department. We also aimed to evaluate the reasons for delayed presentation and to determine possible contraindications for thrombolytic eligible patients.
Results: One hundred and seventeen patients (59% male and 41% female) with a mean age of 63.59±13.66 were studied. Seventy patients had acute ischemic stroke (65.19±12.89), 31 had intracranial hemorrhage, 9 had TIA and 7 patients had the diagnosis of epilepsy, tumor or demantia. Patients who had hemorrhagic stroke were significantly younger than the patients with ischemic stroke (p=0.043). The mean NIH scores of patients with hemorrhagic stroke were higher than the patients with ischemic stroke (p<0.05). The time interval from the onset of symptoms to emergency department presentation was within one hour for 8 patients, three hours for 27 and 6 hours for 49 of the patients. The reasons for delayed presention were admission to an other hospital, living alone and transportation difficulties.
Conclusion: Many causes that were identified in this study for delay in presentation of patients to emergency departments with acute stroke are similar to those presented in other studies. Transportation difficulties stand out as a specific issue causing delay for our patient population.