Stroke signs knowledge and factors delaying acute stroke patients’ hospital arrival in the absence of stroke care systems. A Kinshasa multicenter cross-sectional study

Résumé

Abstract Background The global burden of stroke is overwhelming. Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa.Methods This multicentric cross-sectional study was conducted in all medical facilities in the city of Kinshasa, where medical imaging facilities for stroke diagnosis were available and operational 24 h a day. Patients with stroke and/or accompanying family members were interviewed using a standard questionnaire, and their medical records were reviewed. Factors independently associated with a late arrival (≥ 4.5 h) to the hospital were identified using the logistic regression test in forward multivariate analysis.Results Overall, 202 patients aged 57.9 ± 13.1 years (of whom 106 (52.5%) were men and 96 (47.5%) were women) were included in this study. Only 13% of the patients immediately associated the first symptoms with a stroke episode, and only 29% had the initiative to consult a hospital immediately. Only 10% consulted the recruitment hospital within 4.5 h. Factors independently associated with delayed arrival were age < 60 years (p = 0.014, adjusted odds ratio [aOR] 3.2), being unmarried (p < 0.043, aOR 2.1), low educational level (p = 0.026, aOR 3.4), attending revival churches (p = 0.037, aOR 2.1), lack of stroke awareness (p = 0.002, aOR 2.4), awake consciousness (p = 0.014, aOR 6.5), history of hypertension (p = 0.016, aOR 3.8), history of diabetes mellitus (p = 0.047, aOR 4.3), excessive alcohol consumption (p = 0.038, aOR 2.9), ischemic stroke (p = 0.045, aOR 5.0), and low NIHSS score (p = 0.037, aOR 3.3 ).Conclusions This study depicted a low stroke awareness rate and a much longer prehospital delay than evidence-based guidelines recommend and identified 12 factors that public health actions could target to promote the earliest management of stroke.

Citer ce document

Accès au document

Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter

Auteur(s)

Statistiques

Consultations : 1

Téléchargements : 0