Factors Associated with Pre-Hospital Delay and Intravenous Thrombolysis in China

Early Hospital Arrival After Acute Ischemic Stroke Is Associated With Family Members' Knowledge About Stroke

“…The elderly often thought that the symptoms might disappear automatically and 24.2% of patients were afraid of troubling people that are not their family members, so living with their descendants was associated with early arrival. Furthermore, those who were over 65 years old were independently associated with late arrival and conservative therapy, which was consistent with previous studies results ( 6 , 8 , 14 , 18 , 29 ), but contrasted with others ( 11 , 18 , 30 ). Many people, especially the elderly, who suffer from neurological diseases may be less aware of the signs and symptoms of AIS compared to younger patients in Western China, and they were reluctant to seek medical attention unless they were advised to do so ( 26 , 31 ).…”

“…Similar to many other studies, the present study suggested that the factors such as severe stroke ( 12 , 35 – 37 ), sudden onset symptoms ( 5 , 34 ), onset at daylight ( 16 , 19 ), consciousness disturbance ( 14 , 36 , 38 , 39 ), weakness ( 38 ), and the use of an ambulance ( 5 , 14 , 18 , 19 , 28 , 40 ) were significantly associated with early arrival. In comparison, those who had a prior stroke, a history of hyperlipidemia ( 18 ) or atrial fibrillation ( 5 , 6 , 18 ), had blurred vision in one or both eyes ( 38 , 39 ) or were referred from other hospitals ( 6 , 14 , 41 ) were associated with delayed arrival. Among all the symptoms, only blurred vision was associated with prolonged prehospital delay, whereas weakness and consciousness disturbance could shorten the prehospital delay.…”

“…The median prehospital delay time was 410 min, which was longer than that reported in north Spain (138.5 min) and Switzerland (150 min) ( 17), but shorter than that reported in the China QUEST (Quality Evaluation of Stroke Care and Treatment) study (15 h) (6). The thrombolysis rate in AIS patients was 5.8%, which was lower than the rates of studies in Jiangsu, China (18), London (12), and Nepal (19). The possible reason for this is that the health and education system lag behind due to its relatively backward economic development in Western China.…”

“…This study demonstrated that patients who lived in non-urban areas and had a driving time from the onset place to the hospital of more than 30 min were independently associated with late arrival, which is similar to the results of previous studies ( 5 , 17 ). Although the guidelines emphasized the importance of EMS ( 33 ), long driving time was still the main barrier to receiving AIS therapy due to the uneven distribution of hospitals and choosing to use private cars instead of using EMS in Western China ( 18 ). Patient's whose initial reaction was to call an ambulance, and arrived by ambulance ( 14 , 16 ), were independently associated with early arrival.…”

Cluster-randomised controlled trial of Stroke 1-2-0 education programme to reduce stroke prehospital delay in China: a study protocol

“…10 The prehospital delay was largely attributed to the lack of knowledge about stroke signs and symptoms. [11][12][13][14] In light of the implementation of the Reducing Million New Disable Project, 15 16 which was administered by the National Health Commission, there has been a concerted effort to reduce stroke-related disability and mortality through multifacet strategies, such as general public education, primary and secondary prevention, and in-hospital management. The Reducing Million New Disable project aimed to reduce the number of newly disabled stroke patients by 1 million by 2030.…”