The influence of patient’s knowledge about stroke in Brazil: a cross sectional study

Abstract

Little is known about stroke patients' awareness about the warning signs of stroke and its therapeutic time window in Brazil. Method: We interviewed consecutive patients with acute stroke admitted to a terciary public hospital in Brazil. Data collected included demographics, mode of arrival, National Institutes of Health Stroke Scale (NIHSS) scores and knowledge of stroke warning signs and therapeutic time window. Early arrival was defined as within 4.5 hours of symptoms onset. Results: Although 66.2% of patients knew the warning signs of stroke, only 7.8% reported to know that stroke had a limited therapeutic time window. Stroke severity measured by the NIHSS was independently associated with early arrival, but not knowledge of stroke signs and symptoms. Conclusion: Knowledge about stroke symptoms was not a predictor of early arrival.Keywords: stroke, public awareness, knowledge. RESUMOPouco se sabe sobre o conhecimento dos pacientes com acidente vascular cerebral (AVC) acerca dos sinais de alarme da doença e sua janela terapêutica no Brasil. Método: Foram entrevistados consecutivamente os pacientes com AVC agudo internados em um hospital público terciário no Brasil. Os dados coletados incluíram dados demográficos, o modo de chegada, escala de AVC do National Institute of Health (NIH) e conhecimento sobre a janela de tempo terapêutica e os sinais de alerta do AVC através de um questionário padronizado. Chegada precoce foi definida como aquela dentro de 4,5 horas do início dos sintomas. Resultados: Embora 66,2% dos pacientes sabiam os sinais de alerta do AVC , apenas 7,8% relataram saber que a doença tinha uma janela de tempo terapêutica limitada. A gravidade do AVC avaliada pela escala do NIH foi preditora de chegada precoce, mas conhecimento acerca dos sinais e sintomas do AVC não foram. Conclusão: O conhecimento acerca dos sintomas do AVC não foi preditivo de chegada precoce ao hospital.Palavras-chave: acidente vascular cerebral, sensibilização pública, conhecimento.Stroke is a major public health problem and the leading cause of mortality in Brazil. In 2005, 10% of all deaths in the country (90,006 deaths) as well as 10% of all public hospital admissions were due to stroke 1,2 . Intravenous thrombolytic therapy for ischemic stroke was approved in Brazil in 2001 but the number of patients who have access to stroke reperfusion therapies remains low, despite the advances in stroke treatment in the country 3 . Early hospital presentation is a prerequisite for successful management of acute ischemic stroke 4 . Many factors contribute to delays in seeking for treatment for acute stroke. However, the most important is lack of public awareness regarding stroke symptoms and the need for a rapid response 5 . A previous community-based study has shown alarming lack of awareness about stroke in Brazil. Most of the studies evaluating knowledge about stroke symptoms in the country have been conducted in the general population 6,7,8 . Little is known about stroke patients' awareness about stroke warning signs and i...

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