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Objective: The objective of this research was to reveal the interval from the start of an acute ischemic stroke (AIS) to the patient’s arrival at the reference center, defined as time to treatment, as well as to identify the reasons for delayed presentation when applicable. We also wanted to elucidate whether there were changes in the time to treatment in individuals with a prior diagnosis of AIS compared to those who presented with the diagnosis of AIS for the first time. Additionally, we aimed to assess the rate of thrombolytic treatment administered to the patients.
Methods: This prospective study was conducted with patients aged 18 and above diagnosed with ischemic AIS in the emergency department (ED) during a 3-month period. In total, 150 patients were included in the study. After obtaining written consent, responses of patients were recorded on the data collection form through direct communication or, in the case of those unable to respond, from their close relatives. Radiological data were obtained from hospital records. Statistical Package for the Social Sciences (SPSS) version 17.0 program was used for data analysis.
Results: Among the patients, there were 88 males and 62 females, with an average age of 71.97 ± 13.53 years. From the total group of 150 people, 105 (70%) were experiencing an acute ischemic stroke (AIS) for the first time, while 45 individuals (30%) had a history of prior AIS diagnoses. The mean time to apply to the hospital for treatment was 11.34 ± 19.63 hours. In patients with a history of prior AIS, the mean time to apply for treatment was 11.31 ± 20.2 hours. The number of patients admitted to the ED within the first 1 hour was 30 (20%), while the count of patients who were admitted to the ED within the initial 3 hours was 72 (48%). The rate of those admitted within the first 4.5 hours was 54.7%. The proportion of individuals with a university education among those who presented within the first 3 hours was higher compared to those who did not seek medical attention within the first 3 hours. No significant difference was observed in other parameters examined. The number of patients who received thrombolytic treatment was 49 (32.67%). As a reason for late admission, patients (27%) mostly stated that they waited with the idea that their symptoms would go away on their own. Those who were conscious of early application comprised only 3% of the patients.
Conclusion: The findings showed that patients were not consciously aware of the need for early presentation in the case of AIS. Furthermore, onset-to-door time remained almost the same in patients who had previously presented with AIS, and this naturally reflected on the rate of thrombolytic treatment administration. There is a need to raise awareness about this issue within the community, utilizing media outlets.
Cite this article as: Işık B, Ersoy A. Time between symptom onset and emergency department arrival and thrombolytic treatment rates in patients with acute ischemic stroke. Arch Basic Clin Res. 2024;6(3):170-176.