Factors that affect time delays to fibrinolytic treatment in ischaemic stroke

• Published in: Revista de neurologiá Vol. 51; no. 12; pp. 714 - 720
• Main Authors: Palomino-García, Alfredo, Moniche-Álvarez, Francisco, de la Torre-Laviana, Francisco J, Cayuela-Domínguez, Aurelio, Vigil, Eduardo, Jiménez-Hernández, M Dolores
• Format: Journal Article
• Language: Spanish
• Published: Spain 16.12.2010
• Subjects: Aged; Aged, 80 and over; Brain Ischemia - complications; Brain Ischemia - drug therapy; Emergency Treatment; Female; Fibrinolytic Agents - therapeutic use; Humans; Male; Stroke - complications; Stroke - drug therapy; Time Factors
• ISSN: 1576-6578
• DOI: 10.33588/rn.5112.2010333

Extending the thrombolytic therapy window in ischaemic stroke to 4.5 hours has proved to be useful and safe, but a prompt response remains a decisive factor. To analyse the factors that delay treatment. After activating the Stroke Code procedure, the consecutive cases of stroke attended in the emergency department throughout the year 2006 were recorded; data included their clinical and epidemiological features, origin, means of transport and delay times in the process. Of the total number of patients with ischaemic stroke, 10.1% finished the emergency study with a median of 1 hour to decide to carry out treatment within 3 hours, and 13.1% of them between 3 and 4.5 hours, with a median of 2 hours and 6 minutes. For the analysis of all the variables, 498 patients were selected; 39% were admitted to hospital within the first 3 hours and 11.2% between 3 and 4.5 hours of the onset of symptoms. The use of the emergency telephone system, transport by mobile ICU or ambulance and an impaired level of consciousness, sight or, to a lesser extent, language or speech were related to shorter delay times. The factors that depended on the actual patient, in general, did not shorten the delay time. Clinical severity, the presence of informants and activating the emergency system shortened intervention times.