Pre-Hospital Delaying Factors in Patients of Acute Ischemic Stroke who are Candidates for Thrombolytic Therapy

Kamran Ali; Khurram Haq Nawaz; Wahaj Ul Hassan; Raja Muhammad Waqar

doi:10.51253/pafmj.v73i3.6704

Authors

Kamran Ali Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Khurram Haq Nawaz Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Wahaj Ul Hassan Department of Medicine, Combined Military Hospital, Malir/National University of Medical Sciences (NUMS) Pakistan
Raja Muhammad Waqar Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i3.6704

Keywords:

Acute Ischemic Stroke (AIS), Intravenous thrombolytic therapy (IVT), National Institute of Health Stroke Scale (NIHSS), Pre-hospital delay

Abstract

Objective: To identify and statistically evaluate pre-hospital delaying factors for thrombolysis in Acute Ischemic Stroke (AIS).

Study Design: Cross-sectional study.

Place And Duration OF Study: Emergency/Neurology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2020 to Mar 2021.

Methodology: Patients older than 18 years and who reported to the emergency/Neurology clinic with stroke symptoms were included in the study. The patients or their relatives were interviewed with a detailed questionnaire that recorded patients' National Institute of Health Stroke Scale and other socio-demographic variables. In addition, the patients were grouped based on time of arrival to the hospital: Early (<4.5 hours) and Late (>4.5 hours), and the variables recorded were compared with each other.

Results: Of 98 patients, 71(72.5%) arrived early, and 27(27.5%) arrived late. Seventy patients (72%) were male, and 28(28%) were female. Only 18 patients availed of the ambulance service, whereas the rest of the study participants reached the hospital using private transportation.

Conclusion: Female gender, NIHSS score of 10 or below and using transport other than ambulance adversely affect the hospital arrival time of acute ischemic stroke patients.