A Survey Of Stroke Awareness And Factors Associated With Presentation Delay In Acute Ischemic Stroke Patients

Objective:The main purpose of this project was to investigate the awareness of stroke warning signs and risk factors as well as potential factors affecting treatment time of acute ischemic stroke patients.Methods:Cross-sectional surveys about the awareness of stroke general knowledge, warning signs and risk factors, and the time from symptoms onset to being hospitalized of acute ischemic stroke patients were conducted with the application of a structured questionnaire between December 2014 and June 2015. The relationship between the time of hospital presentation and stroke awareness, degree of neurological deficit, initial symptoms, response to stroke onset, status when stroke happened, previous medical history and demographic information were analyzed. Factors associated with hospital arrival time were investigated with the help of multiple linear regression analysis.Results:133 acute ischemic stroke patients who hospitalized in the neurology department of the First Hospital of Lanzhou University were included. Mean age of the respondents were 63.20±11.46 years, 64.7% of them were male. Weakness(59.4%) was the most commonly identified stroke sign, while hypertension(66.2%) was the most commonly identified stroke risk factors. 24.1% of patients could identify four or more stroke risk factors and 15.0% could identify three or more stroke signs. Patients who could identify four or more stroke risk factors(P=0.021) and three or more stroke signs(P=0.044) in the recurrent stroke group were greater than the first stroke group respectively. The mean onset-to-needle time(ONT) was 2327.27±2157.30 minutes, mean onset-to-door time(ODT) was 1352.89(10.00-8730.00) minutes, mean door-to-needle time(DNT)was 641.16(8.00-5760.00) minutes. ONT and ODT of emergency group were shorter than outpatient group(P=0.000). A multiple linear regression analysis model demonstrated that initial symptom of dizziness(P=0.017) was significantly related to ONT. Without warning sign of dizziness was predictor for longer ONT. A binary logistic regression analysis demonstrated that higher degree of education(P=0.04), live alone(P=0.006) and resting status when stroke onset(P=0.025) were predictors of identifying 3 or more stroke risk factors.Conclusion:Delay of hospital presentation was popular in acute ischemic stroke patients who hospitalized in the neurology department of the First Hospital of Lanzhou University. Without warning sign of dizziness was independent predictor that associated with delay of hospital presentation. Higher degree of education, live alone and resting status when stroke onset were predictors of identifying 3 or more stroke risk factors.