Barriers to thrombolysis in acute ischemic stroke: Experience from a Level 1 hospital in South Australia
- Author:
Sapna E Sreedharan
;
Janakan Ravindran
- Publication Type:Journal Article
- From:Neurology Asia
2011;16(1):17-23
- CountryMalaysia
- Language:English
-
Abstract:
Objective: We studied the mean pre- and in-hospital delay of patients presenting with symptoms
suggestive of acute stroke to assess the major barriers to thrombolysis. Methods: The study was
a retrospective audit of all patients presenting to Emergency Department (ED) of Lyell McEwin
Health Services, Adelaide, Australia with symptoms suggestive of acute cerebral ischemia in the
year 2008. We assessed from ambulance and medical records the time of onset of symptoms, delay
in presentation to ED, and in-hospital delay for evaluation and imaging. Results: Of 216 patients
(Male=123, Female=93) with mean age 70.2 years, 103 (47.7%) presented within 3 hours of onset
of symptoms. 42.85% of acute strokes presented within 1 hour 30 minutes. Only Australasian Triage
Scale Level 1 and 2 had a positive association with completion of evaluation within 1 hour of arrival
to ED. Patients with motor symptoms had less pre-hospital delay as compared with those presenting
with other neurological symptoms. Arrival by ambulance or direct presentation to ED had no signifi cant
impact on pre-hospital delay.
Conclusions: More number of patients are presenting to emergency services within 3 hours of onset
of symptoms suggestive of acute stroke. However present triage system at ED often is inadequate in
capturing all the strokes who are potential candidates for thrombolysis.
- Full text:P020150731373413662307.pdf
