Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience.
eNeurologicalSci
; 14: 68-71, 2019 Mar.
Article
en En
| MEDLINE
| ID: mdl-30671551
BACKGROUND: The use of intravenous recombinant tissue plasminogen activator (IV r-tPA) in early acute ischemic stroke (AIS) management faces a lot of difficulties in developing countries due to lessened guideline development with consecutive pre- and intra-hospital delay. OBJECTIVES: The objective was to identify the barriers facing proper utilization of IV r-tPA for AIS in Tanta University Hospitals. METHODS: The study was conducted on 4124 AIS patients eligible to use IV r-tPA divided to group-I consisting of 442 patients who arrived the hospital within <3.5â¯h from the stroke onset and group-II consisting of 3682 patients who arrived >3.5â¯h from the stroke onset. The former group was further subdivided to 238 patients who received IV r-tPA (group-Ia) and 204 patients who did not receive IV r-tPA (group-Ib) due to different obstacles. RESULTS: The main causes of pre-hospital onset to arrival delay were stroke unawareness, long travel time, incorrect beliefs, non-available neurologists, stroke onset during sleep and multiple causes (18.2%, 20.5%, 12.7%, 9.1%, 16% and 23.5% of cases, respectively). Causes of non-administration of IV r-tPA in eligible patients includes prolonged door-to-needle time, financial restraints, minor strokes, unavailable beds and fear of complications (41.2%, 26%, 12.7%, 11.3% and 8.8%, respectively). CONCLUSION: Increasing the chance of utilizing IV r-tPA for AIS patients' needs regular updating of the stroke chain of survival system to get the highest benefits from the available resources.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
ENeurologicalSci
Año:
2019
Tipo del documento:
Article
País de afiliación:
Egipto
Pais de publicación:
Países Bajos