脑卒中发病后延迟到达医院的相关因素:越南清化省的观察研究

Hoa Thi Truong, Sam Hoanh Guyen, Cuong Van Le, Shinichi Tokuno, Aya Kuchiba, Shinji Nakahara
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引用次数: 0

摘要

背景:延迟入院会降低脑卒中患者接受再通治疗的比例,并导致不良后果。本研究调查了越南清化省脑卒中发病后院前到达医院时间延迟的相关因素:方法:本研究收集了前瞻性登记的中风患者发病 7 天内的临床数据。采用结构化问卷对患者和/或其亲属进行访谈,内容包括患者的社会人口统计学特征、住址、卒中后支持行动和卒中意识。院前到达医院的延迟时间被二分为 4.5 小时和 4.5 小时,并采用多变量逻辑回归分析来研究与延迟相关的因素:在分析的 328 名参与者中,有 181 人(55.4%)在症状出现 4.5 小时后到达医院。患者及亲属对中风的认识不足。对于居住地距离医疗机构 10 公里以外的患者以及中等或以下教育水平的患者,院前延误的时间更长,几率比分别为 2.07 和 1.98。将地区医院或私立医院作为第一医疗点或不使用急诊服务与此无明显关联:讨论:研究显示,大多数脑卒中患者没有及时到医院接受再通路治疗。此外,患者及其亲属对中风的认识不足也令人担忧。需要进一步研究院前延误的原因,并制定有针对性的干预措施,以提高对中风的认识,减少延误。
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Factors Associated with Delayed Hospital Arrival after Stroke Onset: An Observational Study in Thanh Hoa Province, Vietnam
Background: Delayed hospital arrival lowers the proportion of patients with stroke receiving recanalization therapy and results in poor outcomes. This study investigated the factors associated with pre-hospital delays in hospital arrival after stroke onset in the Thanh Hoa Province, Vietnam. Methods: Clinical data were collected from stroke patients within 7 days of symptom onset who were prospectively registered in this study. Patients and/or their relatives were interviewed using a structured questionnaire about patient social demographics, address, post-stroke support actions, and stroke awareness. Pre-hospital delay in hospital arrival was dichotomized into <4.5 hours and > 4.5 hours, and multivariable logistic regression analysis was used to investigate factors associated with the delay. Result: Of the 328 participants analyzed, 181 (55.4%) arrived at the hospital 4.5 hours after the symptom onset. The patients' and relatives' awareness of stroke was poor. Pre-hospital delays were longer for patients living > 10 km away from a healthcare facility and those with secondary or lower education levels, with odds ratios of 2.07 and 1.98, respectively. Seeking care at a district or private hospital as the first point of healthcare or non-use of emergency medical services did not show significant associations. Discussion: The study revealed that most patients with stroke did not arrive at the hospital in time for recanalization therapy. Moreover, the low stroke awareness among patients and their relatives is concerning. Further research is needed to investigate the reasons for pre-hospital delays and develop targeted interventions to improve stroke awareness and reduce these delays.
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