Therapeutic journey of patients affected by stroke: cohort study

Abstract

The therapeutic journey of patients affected by a stroke cause health impacts and deaths. Stroke is an acute neurological dysfunction, classified as hemorrhagic or ischemic. This study aimed to compare the therapeutic journey in the access of patients affected by stroke in hospitals in the Brazilian Northeast.Prospective cohort study, carried in all public hospitals that had a neuroimaging service in the State of Sergipe. The collection instrument sought sociodemographic characterization and timeline. The data were exported to the R Core Team 2022 software. After being coded and tabulated, they were analyzed using descriptive statistics. The hypothesis of independence was tested using Pearson Chi-Square and Fisher Exact tests.A total of 159 patients cared for in the hinterland region of the State and 91 in the capital city (Aracaju) participated in the study, with a median age of 66 years old (SD:55.5-75) in the capital and with a median age of 72 years old (SD:60-82) in the hinterland. There was a predominance in females, 76.6% and 64.1%, respectively. It was found a higher incidence of the ischemic stroke (IS) (p<0.002). The decision time between the onset of signs and symptoms and the decision to call up transportation, it was observed that patients with IS cared for in the hinterland take three times longer (p=0.002). Regarding the time between the stroke detection and the CT scan, it was five times longer for those from the hinterland (p<0.001) in cases of IS. In cases of HS, the time was 1.4 longer for those from the hinterland. Concerning the neurological evaluation, in cases of IS and HS, the rates found were 76.6%vs78.3% in the hinterland, while 100% of patients were evaluated for both types of stroke episodes in the capital city (p<0.001).The therapeutic journey of patients cared for in the hinterland of the State has a longer period of time.