Reasons for Pre-Hospital Delay and Current Situation of Thrombolytic Therapy: A Prospective Study in a Single Center in China.
Neurology India · 2026-01-01 · Observational study
Abstract
BACKGROUND AND OBJECTIVE: The aim was to investigate reasons for a pre-hospital delay in patients with acute ischemic stroke (AIS) and patients within the thrombolytic window who did not receive thrombolysis. SUBJECTS AND METHODS: This study was conducted on AIS patients admitted to the stroke center through interviews and questionnaires. RESULTS: Of the 160 consecutive patients included, 67 (41.9%) arrived at the emergency department (ED) within 4.5 h, and 93 (58.1%) were delayed. The early arrival patients had shorter median onset-to-arrival times (P < 0.001). Of the 93 delayed patients, 70 (75.3%) were unaware of the occurrence of a stroke, and 17 (18.3%) had the stroke onset during sleeping. Multivariate logistic regression analysis showed that private car [odds ratio (OR) 4.310, 95% confidence interval (CI) 1.732-10.728] and other traffic tools (OR 6.189, 95%CI 1.843-20.786) were independent of a delayed arrival, whereas symptomatic remission, symptomatic aggravation, education of stroke, and the Oxfordshire Community Stroke Project classification were independently related to early arriving at the hospital after a stroke. Of the 67 patients, 33 (49.3%) who arrived within the window time did not receive thrombolytic therapy. Except for minor stroke (n = 9/27.3%) and contradictions (n = 2/6.1%), the main reasons for pre-hospital delay were patients' refusal (n = 12/36.4%) and misdiagnosis on the part of the physician due to atypical symptoms (n = 4/12.1%). CONCLUSIONS: Lack of stroke education, symptom stabilization, and non-emergency medical system utilization were the main reasons for the pre-hospital delay. Patients' refusal and misdiagnosis were the main reasons of patients who were eligible for thrombolytic treatment but did not finally receive thrombolysis.
Tags
Antithrombotics & thrombolytics · Thrombolytics · Time intervals