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    Predictors of early arrival at the emergency department in acute ischaemic stroke.

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    Authors
    Curran, C
    Henry, C
    O'Connor, K A
    Cotter, P E
    Affiliation
    Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland.
    Issue Date
    2012-01-31T16:39:47Z
    MeSH
    Acute Disease
    Aged
    Aged, 80 and over
    Brain Ischemia/*diagnosis/*drug therapy
    *Emergency Service, Hospital
    Female
    Health Services Accessibility
    Humans
    Male
    Retrospective Studies
    Time Factors
    *Transportation of Patients
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    Citation
    Ir J Med Sci. 2011 Jun;180(2):401-5. Epub 2011 Feb 6.
    Journal
    Irish journal of medical science
    URI
    http://hdl.handle.net/10147/206353
    DOI
    10.1007/s11845-011-0686-4
    PubMed ID
    21298491
    Abstract
    BACKGROUND: A requirement of an effective acute stroke service is the early arrival of patients to the hospital emergency department (ED). This will allow the possible use of thrombolytic therapy or other acute interventions within a limited time window. AIMS: We investigated the predictors of early arrival in a single hospital serving a mixed urban and rural catchment area. METHODS: A retrospective review of all case notes for 1 year was performed. RESULTS: Of 105 acute strokes, 91 were cerebral infarcts and a total of 71 cases presenting initially to the ED had timing available for analysis. 39.4% presented within 3 h, and 12.7% were potentially suitable for thrombolysis. Those living closer to the hospital were not more likely to arrive within 3 h (Z = -0.411, p = 0.68). Presenting directly to the hospital by emergency services (or private transport) was significantly associated with early arrival in a univariate comparison (p < 0.001), and in a multivariate model. CONCLUSION: The only independent predictor of early arrival to the ED is direct presentation. Improved public education of the importance of recognition of stroke symptoms and rapid contact with the emergency services will improve the early attendance following acute stroke, allowing increased use of acute stroke treatments.
    Language
    eng
    ISSN
    1863-4362 (Electronic)
    0021-1265 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11845-011-0686-4
    Scopus Count
    Collections
    Mercy University Hospital

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