Factors affecting the effective management of acute stroke: A prospective observational study

Abstract

Background:Stroke, characterized by sudden loss of cerebral function, is among one of the leading cause of death and disability world over. The newer treatment modalities have changed the landscape of stroke treatment but are very much time bound.Aim:To characterize pre-hospital and in-hospital factors affecting acute stroke management thus defining lacunae in stroke management.Subjects and Methods:A prospective observational study, conducted at the emergency department of a tertiary care center in southern India from August 2015 to July 2016. All stroke patients presenting within first 24 hours of onset were included. A pre -defined Knowledge-Attitude-Practice (KAP) questionnaire was used.Results:Total of 133 patients were eligible out of which 28 were excluded for various reasons. Majority were >60 years age and male (61%). About 60% arrived within window. Distance from the hospital was one of the major factors for arrival within the window period. When compared by KAP questionnaire, bystanders of those arriving within window period had better awareness of stroke symptoms.Conclusions:Improving awareness of stroke symptoms and increasing availability of EMS is likely increase chances of stroke patients receiving appropriate acute management.

Correlation of Quality Metrics of Acute Stroke Care with Clinical Outcomes in an Indian Tertiary-care University Hospital: A Prospective Evidence-based Study

“…On the contrary, shorter DTN time is associated with minimal complications to thrombolytics and improved patient outcomes (mRS < 2 at 90 days poststroke). 9 , 23 The DTN time in our study (55 minutes) was comparable with the recently published Indian study (54 minutes), 24 whereas it was significantly delayed in another study (100 minutes). 25 We still have scope for more improvement, and efforts are on to further reduce DTN time at our center.…”

Risk Factors Associated with Prognosis in Patients with Acute Stroke: A Retrospective Observational Study

“…According to the findings of other studies, the reasons for the late referral of the patients include pre-hospital emergency barriers, distance from the treatment center, nocturnal stroke, lack of information, and poor public knowledge of timely referral (12). Time is one of the major factors influencing the treatment of patients with acute stroke; moreover, the shortening of the time between the onset of symptoms and arrival at the hospital is effective in reducing the negative effects of stroke (14).…”

Are we aware of stroke risk factors and warning signs amid COVID-19? Knowledge and attitude towards risk-factors, signs and symptoms of stroke among the UAE population during COVID-19 pandemic: A cross-sectional study

“…18 Factors influencing the management of stroke include awareness of stroke signs and symptoms, awareness of the importance of early management, educational level, distance from the hospital, and past history of stroke. 19,20 Identifying baseline stroke knowledge in the general population is crucial to developing effective, targeted, and appropriate health promotion programs for stroke prevention. There is limited data on people's knowledge and attitudes towards stroke in the UAE.…”