Stroke signs knowledge and factors associated with a delayed hospital arrival of patients with acute stroke in Kinshasa
Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa. Patients with str...
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| Published in: | Heliyon Vol. 10; no. 7; p. e28311 |
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| Main Authors: | , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier Ltd
15-04-2024
Elsevier |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa.
Patients with stroke and/or accompanying family members were interviewed using a standard questionnaire, and their medical records were reviewed. Factors independently associated with a late arrival (≥4.5 h) to the hospital were identified using the logistic regression test in forward multivariate analysis.
Overall, 202 patients with an average age of 57.9 ± 13.1 years were included. Only 27 (13.4%) patients immediately associated the initial symptoms with a stroke episode. Delayed hospital arrival was observed in 180 (89.1%) patients. Unmarried status (adjusted odds ratio [aOR], 2.29; 95% confidence interval [CI], 1.17–4.88; p = 0.007), low education level (aOR, 2.29; 95% CI, (1.12–5.10; p = 0,014), absence of impaired consciousness (aOR, 3.12; 95% CI, 1.52–4.43; p = 0.005), absence of a history of hypertention (aOR, 1.85; 95% CI, 1.18–3.78; p = 0.041), absence of a history of diabetes (aOR, 1.93; 95% CI, 1.15–4.58; p = 0.013), heavy alcohol consumption (aOR, 1.83; 95% CI, 1.12–2.83; p = 0.045), absence of a severe to very severe stroke (aOR, 4.93; 95% CI, 0.82–1.01; p = 0.002), and presence of ischemic stroke (aOR, 2.93; 95% CI, 1.54–4.59; p = 0.001) were identified as independent determinants of delayed hospital arrival.
This study depicted a low stroke awareness rate and a much longer prehospital delay than evidence-based guidelines recommend and identified eight factors that public health actions could target to promote the earliest management of stroke.
•Only 27 (13.4%) patients immediately recognized their stroke warning signs.•149 (73.8%) patients originally went to hospitals without stroke management platforms or staff.•A delayed hospital arrival occurred in the vast majority of patients (89.1%).•The delayed hospital arrival was increased fivefold when the stroke is not severe.•Non-diabetic and non-hypertensive patients had a threefold risk of delayed arrival. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 2405-8440 2405-8440 |
| DOI: | 10.1016/j.heliyon.2024.e28311 |