Factors delaying hospital arrival of patients with acute stroke.

INTRODUCTION: To determine the proportion of patients with acute stroke presenting late to hospital and to identify the factors that delay hospital arrival of patients with acute stroke. METHODS: A cross sectional study was carried out between Sept 2006 to Feb 2007 in the department of Neurology, Liaquat National Hospital Karachi. All patients of both genders, ago >18 years with symptoms of stroke and neuro- imaging (CT scan/MRI brain) findings consistent with stroke were included. RESULTS: Atotal of 165 patients attending the Emergency department were included. There were 86 (52%) males and 79 (47.9%) females. The mean age was 60.04+/-13.98 years, (males 58.2 years and females 61.9 years). The median delay from onset of symptoms to hospital arrival was six hours. Only 28.5% of the patients came within three hours while 71.5% after three hours. Attendants of 47 patients had a low throat perception, 53 (32%) of the patients did not know a single symptom of stroke and 63% (104) patients first contacted their General Practitioner who referred them to hospital. Similarly 60.6% of patients wore first taken to a local hospital not equipped to handle major emergencies. CONCLUSION: Time elapsed from onset of symptoms to hospital arrival is influenced by lack of knowledge of stroke symptoms, contact with a local doctor, low threat perception and non availability of ambulance services.