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学科主题: 临床医学
题名:
Factors Associated With Prehospital Delays in the Presentation of Acute Stroke in Urban China
作者: Jin, Haiqiang1; Zhu, Sainan2; Wei, Jade W.3,11; Wang, Jiguang; Liu, Ming4; Wu, Yangfeng5; Wong, Lawrence K. S.7; Cheng, Yan8; Xu, En9; Yang, Qidong10; Anderson, Craig S.11; Huang, Yining1; ChinaQUEST Quality Evaluation Stro
关键词: acute stroke ; China ; prehospital delay ; stroke ; stroke onset
刊名: STROKE
发表日期: 2012-02-01
DOI: 10.1161/STROKEAHA.111.623512
卷: 43, 期:2, 页:362-370
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Peripheral Vascular Disease
研究领域[WOS]: Neurosciences & Neurology ; Cardiovascular System & Cardiology
关键词[WOS]: TRANSIENT ISCHEMIC ATTACK ; IN-HOSPITAL DELAYS ; EMERGENCY-DEPARTMENT ; ADMISSION ; TIME ; MULTICENTER ; CARE ; THROMBOLYSIS ; HEMORRHAGE ; KNOWLEDGE
英文摘要:

Background and Purpose-Low rates of thrombolysis for ischemic stroke in China have mainly been attributed to delays in presentation to the hospital. This study aimed to evaluate factors associated with these delays.

Methods-Data were from a prospective, multicenter, hospital-based registry of patients with acute stroke (ChinaQUEST [Quality Evaluation of Stroke Care and Treatment]), which involved 62 hospitals across a variety of economic and geographic regions in China during 2006. Univariate and multivariate analyses were undertaken to determine associations between variables of interest and delays to hospital presentation.

Results-Median time to hospital presentation was 15.0 hours for 6102 cases (interquartile range, 2.8-51.0 hours). A total of 1546 (25%) patients arrived within 3 hours and 2244 (37%) patients arrived within 6 hours after symptom onset. Factors that prolonged time to presentation were: visiting a local doctor before presenting at emergency (OR, 0.48; P<0.001), symptom onset at home (OR, 0.62; P<0.001), transfer to a large (Level III) hospital for management (OR, 0.70; P=0.04), and history of diabetes (OR, 0.78; P=0.01). In contrast, factors that accelerated presentation to the hospital were hemorrhagic stroke (OR, 2.25; P<0.001), history of atrial fibrillation (OR, 1.94; P<0.001), unconsciousness at presentation (OR, 1.91; P<0.001), transfer by ambulance (OR, 1.91; P<0.001), and history of coronary artery disease (OR, 1.20; P=0.04).

Conclusions-Health promotion strategies to improve community awareness of early symptoms of stroke, establishment of an alert system to cater for patients likely to experience stroke at home, and wider availability and use of ambulance services are promising methods to help expedite presentation to hospital poststroke and thereby improve the management of stroke in China. (Stroke. 2012;43:362-370.)

语种: 英语
项目资助者: Macquarie Bank Foundation ; George Foundation ; AstraZeneca Pharmaceutical China
WOS记录号: WOS:000299798300018
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55366
Appears in Collections:北京大学第一临床医学院_神经内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Dept Neurol, Beijing 100034, Peoples R China
2.Peking Univ, Hosp 1, Dept Biostat, Beijing 100034, Peoples R China
3.Shanghai Jiao Tong Univ, Sch Med, Ctr Epidemiol Studies & Clin Trials, Ruijin Hosp, Shanghai 200030, Peoples R China
4.Sichuan Univ, Dept Neurol, W China Hosp, Chengdu 610064, Peoples R China
5.Peking Univ, Hlth Sci Ctr, George Inst China, Beijing 100871, Peoples R China
6.Peking Univ, Hlth Sci Ctr, Clin Res Inst, Beijing 100871, Peoples R China
7.Chinese Univ Hong Kong, Prince Wales Hosp, Hong Kong, Hong Kong, Peoples R China
8.Tianjin Med Univ, Gen Hosp, Tianjin, Peoples R China
9.Guangzhou Med Coll, Affiliated Hosp 2, Guangzhou, Guangdong, Peoples R China
10.Univ South, Xiangya Hosp Ctr, Changsha, Hunan, Peoples R China
11.Royal Prince Alfred Hosp, George Inst Global Hlth, Sydney, NSW, Australia
12.Univ Sydney, Sydney, NSW 2006, Australia

Recommended Citation:
Jin, Haiqiang,Zhu, Sainan,Wei, Jade W.,et al. Factors Associated With Prehospital Delays in the Presentation of Acute Stroke in Urban China[J]. STROKE,2012,43(2):362-370.
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