Authors (including presenting author) :
Yu CTM(1),Kwok WYV(2),Lo WT(2),Yuen MKB(2),Chan ST(2),Fong CS(2),Tam YM(3), NG PW(3),Fong WC(2)
Affiliation :
(1)Nursing Services Division,United Christian Hospital
(2)Department of Medicine,Queen Elizabeth Hospital
(3)Department of Medicine and Geriatrics,United Christian Hospital
Introduction :
Time is a crucial factor in hyper-acute stroke management.Early hospital arrival, higher chance to improve therapeutic success for acute ischemic stroke patients.Excessive hospital delay between acute stroke onset and hospital arrival is an ongoing problem in Hong Kong.We investigated the factors associated with early arrival in two acute stroke units in United Christian Hospital(UCH) and Queen Elizabeth Hospital(QEH)
Objectives :
Identify and modify the key factors to promote early hospital arrival and improve stroke outcomes
Methodology :
It is a prospective,consecutive study that explored the factors influencing the arrival time from stroke onset until patient arrival at the Emergency Department(ED).Closed questionnaire will be administered to consecutive patients with acute ischemic stroke arrived hospital within 24 hours in two hospitals.The data of demographic, socio-economic, clinical symptoms and personal characteristics related to early hospital arrival would be obtained in the questionnaire and further analyzed.
Result & Outcome :
From March 2017 to August 2018, a total of 250 patients (125 from UCH; 125 from QEH) were included in this study. A significant hospital delay was found in this study and only 81(32.4%) patients arrived to hospital within three hours. Poor senses of stroke awareness would affect the decisions after stroke onset significantly. 102 (40%) patients attended ED immediately after stroke onset and 132(53%) patients escorted by ambulance to ED.The promulgation of stroke related information should be planned more strategically.Only 128 (51.2%) patients received stroke related information before symptoms onset.Furthermore,some of the stroke patients and bystanders were misled by various kinds of inappropriate information which delay their hospital arrival time.These factors were consistently associated with early arrival in both hospitals.
The associated factors which delayed the arrival time can be modified.The effective ways to promote early hospital arrival are dissemination of stroke information,clarify the inappropriate stroke information and stroke awareness promulgation in the public.Thus,we put many efforts in the past. However,the results reflect that the strategies of stroke awareness promulgation are not effective.The mass media broadcast of stroke related messages and re-engineer the strategies in enhancing stroke awareness are the effective ways to promote early stroke arrival.
