Study on delay factors and time to hospital arrival after acute stroke in patients at Shahid Rajaei hospital, Tonekabon (2022-2023).

Abstract

Background: Stroke is a sudden focal neurological deficit caused by vascular damage to the central nervous system. Globally, stroke is a leading cause of death and disability, with a particularly significant burden in low- and middle-income countries. In Iran, the incidence of acute stroke is increasing, and the age of onset is lower compared to developed countries. This study examines factors causing pre-hospital delays in acute stroke patients at Shahid Rajaei Hospital, Tonekabon, North of Iran (2022-2023). Timely intervention is critical for improving outcomes, as delays significantly affect treatment effectiveness. This study aims to identify the primary causes of pre-hospital delays in acute stroke patients and provide actionable insights to enhance timely intervention strategies, ultimately improving patient outcomes.

Methods: A retrospective descriptive-analytical study was conducted on 150 acute stroke patients using census sampling. Data included demographics, symptoms, and time intervals from onset to hospital arrival. Analysis was performed with SPSS using chi-square, T-tests, and ANOVA.

Results: Of the 150 patients, 81.3% arrived over 4.5 hours after symptom onset, missing the thrombolytic treatment window. Statistical analysis revealed significant associations between some demographic and clinical factors: shorter distances to the hospital and faster arrival (p = 0.037), presence of a witness (p = 0.041), and stroke onset during the daytime (p = 0.002) were linked to reduced delays. Marital status also influenced arrival times significantly (p = 0.007). Other delay factors included unawareness of stroke symptoms (46%), being alone (14.7%), and symptoms occurring during sleep (8.6%).

Conclusions: The study highlights the need for public education on stroke symptoms and improved emergency systems to reduce delays. Addressing these gaps can enhance patient outcomes, especially in areas with limited awareness and resources.