Clinical Research in Stroke

Mainz J.a· Andersen G.a· Valentin J.B.b· Gude M.F.c· Johnsen S.P.b

Author affiliations

aDanish Stroke Center, Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
bDanish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
cDepartment of Research and Development, Prehospital Emergency Medical Services, Central Denmark Region and Aarhus University, Aarhus, Denmark

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Article / Publication Details

First-Page Preview

Received: March 11, 2022
Accepted: August 05, 2022
Published online: October 31, 2022

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Introduction: We aimed to determine the treatment delay for ischemic stroke patients in Denmark. Methods: A nationwide register-based study on acute ischemic stroke patients admitted through emergency medical services. Treatment delay comprised patient, prehospital, and in-hospital delay. Analyses were stratified according to length of prehospital delay (<3 vs. ≥3 h). Results: A total of 5,356 ischemic stroke episodes were included. The median onset-to-door time was 187 min, and 2,405 (43%) arrived at the stroke unit within 3 h. Overall, the median patient delay was 115 min. For early arrival (n = 2,280), patient delay was 27 min compared to 437 min for late arrivals (n = 2,448). Median prehospital delay varied by 9 min between early- and late-arriving patients. Approximately 48% of the early-arriving patients compared to 9% of the late-arriving patients received i.v. thrombolysis. For thrombectomy, the numbers were 10% and 3%, respectively. This corresponded to an unadjusted relative risk (RR) of 0.18 (95% CI: 0.16–0.21) and adjusted (age, sex, cohabitation status, and stroke severity) RR of 0.20 (95% CI: 0.18–0.23) for i.v. thrombolysis when comparing patients arriving later than 3 h with patients arriving earlier. For thrombectomy, the unadjusted and adjusted RRs were 0.30 (95% CI: 0.23–0.39) and 0.40 (95% CI: 0.31–0.52), respectively. Conclusions: Patient delay remains the most important barrier for use of reperfusion therapy among acute ischemic stroke patients calling 1-1-2, whereas system delay seems independent of patient delay.

© 2022 S. Karger AG, Basel

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First-Page Preview

Received: March 11, 2022
Accepted: August 05, 2022
Published online: October 31, 2022

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

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