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Delay in arrival to the emergency room (ER) may negatively influence outcome of stroke patients. We aim to analyze factors that influence extra-hospital delay in stroke patients. Two hundred and ninety-two consecutive stroke patients admitted in the ER were prospectively studied. Analysis was made to identify variables associated with <1- and <3 h delays from onset. About 18.8% of patients arrived before 1 h and 57.5% before 3 h. Factors independently associated with <3 h delay were decision to go immediately to ER (OR = 8.17; 95% IC = 4.47-18.8), ambulance transportation (OR = 2.35; 1.36-4.05) and total anterior circulation syndrome (TACS) (OR = 3.74; 1.51-9.24). History of >1 vascular risk factor was associated with a greater delay (OR = 0.47; 0.26-0.86). Factors associated with a <1 h delay were: (i) immediate decision to attend the ER (OR = 3.55; 1.85-6.81), (ii) stroke on Sunday (OR = 3.46; 1.56-7.66), (iii) aphasia (OR = 2.41; 1.23-4.74), (iv) absence of stairs at home (OR = 0.37; 0.17-0.81) and (v) absence of diabetes mellitus (OR = 0.42; 0.20-0.88). In our area, nearly 60% of stroke patients arrive to ER before 3 h from onset. Immediate decision to attend the ER has the strongest association with a short delay. Patients with TACS arrived mainly before 3 h and those with isolated aphasia arrived before 1 h. Patients with vascular risk factors attended the hospital later. Ambulance transportation is associated with <3 h delay, but not with <1 h.

This cross-sectional study does not allow a definitive conclusion about the relationship between ghrelin levels and sarcopenia. Further large prospective studies are needed to test this hypothesis.

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