Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience

Bahnasy, Wafik Said; Elhassanien, Mahmoud Ebrahim Mostafa

doi:10.1016/j.ensci.2019.01.003

Cited by 22 publications

(26 citation statements)

References 22 publications

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“…In a study in Egypt, only 5.8% of those who were eligible for receiving intravenous thrombolysis received intravenous rtPA which is to a large extent lower than our study results. Their study showed that the Mean±SD onset-to-arrival time was 147.2±42.5 min and the Mean±SD DNT was 87.5±16.4 min [18]. In comparison with the current study, they had a better arrival time even though our DNT is much better.…”

Section: Discussioncontrasting

confidence: 67%

“…This result is in line with the work of Wafkin and colleagues who reported that the main causes of prehospital onset-to-arrival delay were stroke unawareness, long travel time, incorrect beliefs, non-available neurologists, stroke onset during sleep. Also, the causes of in-hospital delays include prolonged DNT, financial restraints, minor strokes, unavailable beds, and fear of complications [18].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Symptom-to-needle Times in Acute Ischemic Stroke and Its Prehospital Related Factors

Hosseininezhad

Tabari-Khomeian

Moaddabi

et al. 2020

Caspian J Neurol Sci

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Background: Intravenous (IV) recombinant tissue Plasminogen Activator (rtPA) (IV-rtPA) is the only FDA-approved pharmacological therapy for treatment in acute ischemic stroke and the administration of IV-rtPA is crucially time-dependent. Objectives: This study aimed to evaluate symptom-to-needle time and factors associated with the prehospital delay in patients with acute ischemic stroke referred to Poursina Hospital, a referral hospital in the north of Iran. Materials & Methods: In this cross-sectional study, all patients with acute stroke referred to Poursina Hospital from June to December 2016 were evaluated. The study data were extracted from the patients’ records. SPSS v. 21 was used to analyze the obtained data. The independent samples t-test and the Chi-square test were used to explore the appropriate relation of variables. Results: A total of 322 patients were included. Their mean age was 74.4 years and 55.6% were male. According to findings, only 74 patients (22.98%) were transferred to the hospital via Emergency Medical Service (EMS), most of them (64.86%) arrived at the right time. There is a significant relationship between EMS transfer use and arriving at the hospital at the right time. Overall, 13.9% of patients received IV rtPA, and 75.5% of the patients received rtPA in less than 60 minutes. Among the patients arrived in the golden time, the average times to treatment were as follows: onset-to-door (OTD), 105 min; door-to-admission, 3 min; admission-to-doctor, 7 min; doctor-to-Computed Tomography (CT), 15 min; CT-to-treatment, 26 min; symptom to needle time, 152 min; and door-to-needle time (DNT), 49 min. Conclusion: According to this study, although the two-third of eligible patients were transferred to the hospital at the right time, the rate of using EMS for patient transportation is low.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Symptom-to-needle Times in Acute Ischemic Stroke and Its Prehospital Related Factors

Hosseininezhad

Tabari-Khomeian

Moaddabi

et al. 2020

Caspian J Neurol Sci

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show abstract

“…Kalimantan selatan merupakan provinsi yang luas, sehingga diperlukan transportasi yang baik untuk pasien stroke. Dengan mengingat waktu golden time dalam pengobatan stroke adalah ± 3 jam, yang berarti bahwa dalam 3 jam pertama setelah terindikasi stroke, perawatan lengkap dan optimal harus segera didapat pasien agar usaha pengobatan yang dilakukan berhasil (Bahnasy, Ragab, & Elhassanien, 2019) Penatalaksanaan dan pengobatan yang cepat tidak hanya membuat perbedaan antara hidup dan mati, tetapi juga dapat mengurangi kecacatan jangka panjang dan komplikasi lainnya. Komplikasi neurologis termasuk perkembangan stroke iskemik, transformasi hemoragik simptomatik, stroke berulang sejak onset stroke (Asgedom et al, 2020).…”

Section: Pendahuluanunclassified

“…Pengangkutan pasien yang tepat waktu dan aman dari tempat gawat darurat ke fasilitas perawatan kesehatan yang sesuai untuk perawatan lebih lanjut adalah proses yang kompleks (Tiwary, Nilima, Majumdar, Singh, & Khan, 2020 Berdasarkan tabel 5 menunjukkan waktu tempuh antara lokasi berangkat dengan instalasi gawat darurat RSUD Ratu Zaleha didapatkan hasil 17 informan (56,57%) ≥165 menit. Waktu emas (golden window) dalam penanganan stroke adalah ± 3 jam, artinya dalam 3 jam awal setelah mendapatkan serangan stroke, pasien harus segera mendapatkan terapi secara komprehensif dan optimal dari tim gawat darurat rumah sakit untuk mendapatkan hasil pengobatan yang optimal (Bahnasy et al, 2019). Keterlambatan pra-rumah sakit, yang diukur dengan total waktu transportasi yang melebihi pedoman bisa disebabkan oleh musim (cuaca) dan pusat pelayanan gawat darurat yang tersedia (Golden & Odoi, 2015).…”

Section: Alasan Penggunaan Transportasiunclassified

Transportasi Pasien Stroke ke Instalasi Gawat Darurat Rumah Sakit

Hidayat¹,

Agianto²,

Agustina³

2020

JHNS

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The prevalence of stroke in Indonesia increased from 7.0/mile to 10.9/mile. The facilities and infrastructure become a national problem especially in the health sector. The initial 3 hours of a stroke is the time span for treatment and help to obtain optimal results. Objective: The purpose of this study was to determine the transportation of stroke patients to the emergency department at Ratu Zaleha Martapura Hospital. Method: This research was analytic descriptive with cross sectional approach and consecutive sampling technique was used to get 30 samples. The study was conducted from October to November 2019 using a questionnaire. Data analysis included frequency and percentage tables. Results: The results showed that 46.47% of respondents used non-ambulances, 73.34% of the reasons were free, 53.33% of medical devices in their modes of transportation were not available, 56.67% of respondents stated that the travel time to the hospital was ≥165 minutes, 50% during the transportation process was not accompanied by a health worker, and for the distribution of locations was the most in the District of Martapura as much as 26,67%. Conclusion: Many stroke patients who were taken did not use ambulances, many were used for free reasons, the majority of medical devices in the mode of transportation were not available, most patients took more than 3 hours and when referred were partly not accompanied by a health worker and the majority of patients were from Martapura District.

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“…In another study in Egypt, the mean onset-to-arrival time was 147.2 minutes and the mean time between the hospital arrival and rTPA injection was 87 minutes. The main causes of delay in patients were misperception of stroke symptoms and long distances from health centers (22).…”

mentioning

confidence: 99%

Factors affecting pre-hospital and in-hospital delays at time-to-treatment and complications in stroke: A prospective cohort study

Ghadimi¹,

Hanifi²,

Dinmohammadi³

2020

Preprint

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Background: Time-to-treatment affects the outcomes of acute ischemic stroke (AIS). The aim of this study was to determine the factors affecting pre-hospital and in-hospital delays in the time-to-treatment and complication in AIS. Methods: This prospective study was performed on 204 AIS patients referred to the stroke care unit in Iran (Zanjan) in 2019. Data were completed by interviewing the patients, their families, records, and observations. The mortality and complication rates were recorded for 30 post-stroke days through call follow-up. Results: The results showed that the highest delay was related to the onset-to-arrival time (288.19 ±339.02 minutes). Results of logistic regression showed that treatment delay declined significantly by consulting followed by symptoms onset, patient transfer through emergency medical service to the hospital, and patients’ understanding of AIS symptoms. The results also showed that increasing the onset-to-treatment time (P< .001) and high National Institutes of Health Stroke Scale (NIHSS) score (P< .000) were the most important factors associated with post-stroke complications. High age (P< .044) and high NIHSS scores (P< .001) were significantly associated with mortality in patients with AIS. Conclusion: Informing people about AIS symptoms and referring to AIS treatment units are essential in reducing the treatment time.

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Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience

Cited by 22 publications

References 22 publications

Symptom-to-needle Times in Acute Ischemic Stroke and Its Prehospital Related Factors

Symptom-to-needle Times in Acute Ischemic Stroke and Its Prehospital Related Factors

Transportasi Pasien Stroke ke Instalasi Gawat Darurat Rumah Sakit

Factors affecting pre-hospital and in-hospital delays at time-to-treatment and complications in stroke: A prospective cohort study

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