Information from the abstract
Background: Acute ischemic stroke is a leading cause of death and disability. Timely hospital arrival is critical for effective reperfusion therapy. Objectives: This study aimed to identify factors influencing hospital arrival time and to assess the impact of emergency medical services (EMS) use on clinical outcomes among ischemic stroke patients at Buddhasothorn Hospital. Methods: We conducted an ambispective observational cohort study of 195 patients with acute ischemic stroke admitted between January 2023 and May 2024, incorporating both retrospective medical record reviews and prospective patient interviews. We analyzed data on baseline characteristics, mode of transport, arrival time, and National Institutes of Health Stroke Scale (NIHSS) scores. Measures of association for delayed arrival (≥4.5 hours) were assessed using multivariate logistic regression to estimate adjusted odds ratios (aORs). Results: Among 195 patients, 76 (38.9%) arrived within 4.5 hours of symptom onset, and 33 (16.9%) used EMS. Patients arriving within 4.5 hours had significantly lower discharge NIHSS scores compared with those arriving later (3.43 vs. 4.39, p = 0.010). EMS utilization was independently associated with a lower likelihood of delayed hospital arrival (aOR = 0.11, 95% CI: 0.02–0.81, p = 0.030). Additionally, patients with timely arrival demonstrated a greater reduction in mean NIHSS score compared to those with delayed arrival (mean difference in score improvement: 0.96 points, 95% CI: 0.23–1.69). Conclusion: Early hospital arrival within 4.5 hours is associated with better stroke outcomes, yet the majority of patients still present late. EMS use is independently associated with reduced prehospital delay but remains underutilized.
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Related topics: Acute Ischemic Stroke Management · Hospital Admissions and Outcomes · Trauma and Emergency Care Studies
Thai researcher and institutional participation
Sirinapa Saneemanomai · Phatchapong Rurgring · Thinnapat Ninthasuk · Juthatip Rooyoo · Jidaporn Burenoi · Neera Krasaesoontorn · Benjawan Saengluan · Nunnaphat Khantiviriyapanich · Kanokporne Nakboon · Rajabhat Rajanagarindra University · Thammasat University Hospital
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