Factors Influencing Pre-Hospital and In-Hospital Delays at Time-To-Treatment and Complications in Stroke: A Prospective Cohort Study

Abstract

Abstract Background: The results of acute ischemic stroke (AIS) are highly affected by time-to-treatment. This study aimed at determining the factors influencing the in-hospital and pre-hospital delays in the complications and time-to-treatment in AIS. Methods: The present prospective study was carried out on 204 AIS patients referring to the stroke care unit in Zanjan, Iran (2019). To collected the required data, the patients and families were interviewed, as well as using the observations and records. The complication and mortality rates were recorded for 30 days after stroke via call follow-ups. Results: Based on the obtained results, the maximum delay was associated with the onset-to-arrival time (288.19 ±339.02 minutes). The logistic regression results indicated a statistically significant decline in the treatment via consultation after initiating the symptoms, transferring the patient to the hospital via emergency medical service, and the patients’ comprehension regarding the AIS symptoms. It was also found that an increase in the onset-to-treatment time (P <.001) and higher National Institutes of Health Stroke Scale (NIHSS) scores (P< .001) are the most critical factors related to the post-stroke complications. The higher age (P <.044) and NIHSS scores (P < .001) were considerably related to the mortality in AIS patients. Conclusion: It is essential to inform people regarding AIS indicators and referring to AIS treatment units to reduce the treatment time.