Stroke Awareness and Factors Influencing Hospital Arrival Time: A Prospective Observational Study
Sattawut Wongwiangjunt MD*, Chulaluk Komoltri DrPH**, Niphon Poungvarin MD, FRCP, FRI*, Yongchai Nilanont MD*
Affiliation : * Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Clinical Epidemiology, Department of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Data concerning stroke awareness and factors associated with time of hospital arrival for acute stroke patients
in Thailand are still lacking.
Objective : To assess stroke awareness and to identify factors influencing hospital arrival time after an acute stroke.
Material and Method: This is a prospective study comprising consecutive acute stroke patients admitted in Siriraj Hospital,
Bangkok, Thailand between August 2010 and December 2011. Demographic data, stroke severity using the NIHSS, diagnosis
and stroke awareness questionnaire were collected.
Results : Of 217 acute stroke patients, mean age was 6613.7 years. Mean stroke severity was 107.6. Patients arrived at
the Emergency Department within 4.5 hours (early hospital arrival: EHA) in 38.2% of the cases, 16.6% by ambulance.
Only 34.6% of patients recognized that they were having stroke. Factors associated with EHA were 1) stroke awareness
(OR 1.96, 95% CI 1.07-3.60, p = 0.030), 2) arrival by ambulance (OR 2.23, 95% CI 1.03-4.81, p = 0.042), and 3) NIHSS
>15 (OR 2.26, 95% CI 1.17-4.35, p = 0.015).
Conclusion : Only one-third of patients were aware of stroke symptoms. Only one in six patients used emergency transportation.
Public educational campaign is needed to increase the community awareness of stroke warning symptoms and the urgent
emergency medical services.
Keywords : Stroke awareness, Acute stroke, Hospital arrival time
