Introduction: Stroke is a leading cause of morbidity and mortality worldwide, and timely intervention is crucial for improving outcomes. In Nepal, where stroke care is evolving, understanding the epidemiological characteristics and treatment delays is essential for improving emergency care strategies.
Aim: The study aimed to determine the epidemiological profile of stroke cases and explore the reasons for delays in stroke treatment.
Methods: This explanatory sequential mixed-methods study was conducted in the General Practice and Emergency Department (GPED) of Tribhuvan University Teaching Hospital (TUTH) to investigate stroke presentations and treatment delays. Quantitative data collection involved analyzing medical records from August 2022 to September 2023 to establish the epidemiological profile of stroke cases. In addition, 18 in-depth interviews were conducted between February 2024 and March 2024, including 10 stroke patients and 8 family members, to investigate factors contributing to treatment delays. Data analysis included descriptive statistics for quantitative data using STATA version 17 and rapid analysis for qualitative data using MS Excel.
Results: The prevalence of stroke among patients was 2.96% [95% CI: 2.86-3.10], with ischemic stroke being the most common type at 76.34% [95% CI: 73.52-79.06]. The average age of stroke patients was 61.79 years, and 60% of the patients were male. The qualitative findings revealed several important factors that contributed to delays in treatment, such as a lack of awareness of symptoms, limited access to thrombolysis services, delayed diagnosis due to atypical presentation by healthcare professionals, and financial obstacles to accessing treatment.
Conclusions: These findings highlight the importance of enhancing stroke symptom recognition, improving access to thrombolysis services, and addressing financial barriers to treatment. Policy interventions to promote stroke awareness and enhance healthcare infrastructure are warranted to reduce treatment delays and improve patient outcomes.
