Factors Affecting Thrombolysis of Stroke in Emergency Department of a Tertiary Care Hospital
Journal Title: Indian Journal of Emergency Medicine - Year 2019, Vol 5, Issue 3
Abstract
Introduction: Stroke is leading cause of disability in adults and each year millions of stroke survivors has to adoptlife with restriction in activities of daily living as a consequence of stroke. Time is brain, early recognition of acute ischemic stroke is important because IV fibrinolytic treatment should be provided as early as possible, generally within 3 to 4.5 hours of onset of symptoms. Delay in presentation resulting in increased morbidity and mortality. Methods: All patients with age above 18, suspected stroke, fulfilling the Inclusion criteria at the Emergency Medicine department Bangalore Baptist Hospital, during one and half years period were enrolled in study. Diagnosis can be made on neurological assessment and neuroimaging. Data collection—Administration of questionnaire and data entry. The data collected will be entered into an excel sheet and the analysis will be done using relevant statistical methods. The characteristics of patients’ with acute stroke will be analyzed by using chi-square analysis for categorical variables and the t-test for continuous variables. Statistical analyzes will be performed using the Statistics Package for Social Scientists. Results: Out of 184 patients in the study, there were a total of 46 patients who arrived hospital within 6 hours of onset of symptoms and the rest arrived after 6 hours of onset of symptoms. A p-value of (p<0.0005) as arrived, which is significant for this study. In our study out of 184 patients who presented to emergency with symptoms of stroke, 183 patients were identified within 25 minutes. One patient was not identified who was presented beyond 6 hours of symptom onset. Once we identified that patient arrived in window period (n=5), we performed CT scan within 25 minutes (p<0.0005) and interpretation within 45 minutes (p<0.0005) and thrombolysis of these patients started within one hour (p<0.0005) which is statistically significant. Conclusion: We found that in our study prehospital factor the distance from hospital is significant factor associated with delay in arrival to hospital. It is recommended that creating awareness among general public about stroke symptom and thrombolysis is at most need of the hour. Strengthen of ambulance services and training people (paramedics and EMT) who are involved in first contact with the patient, so that identification of stroke will happen at field.
Authors and Affiliations
M Mahammad Rafi
Keywords
Related Articles
- EP ID EP668702
- DOI 10.21088/ijem.2395.311X.5319.4
- Views 113
- Downloads 0
Serum Magnesium Level in Type 2 Diabetes Mellitus and its Relationship with Glycemic Control and Diabetic Complications
Introduction: Diabetes is frequently associated with Mg deficit. The most but not all diabetic subjects have low magnesium (Mg). Hypomagnesaemia has been reported to occur in 25-38% of patients with Type 2 DM especially...
Association between Carotid Artery Intima-Media Thickness and Cerebrovascular Accident: Prospective Observational Study
Introduction: Ischemic cerebrovascular accident (CVA) is often a sequel of atherosclerotic disease. Common carotid artery intima-media thickness (CIMT) is a surrogate marker of early atherosclerotic changes. Aim of our s...
Study of Acute Myocardial Infarction in Post Menopausal Women with Special Reference to Dyslipidemia
Introduction: Coronary artery disease is a leading cause of mortality among postmenopausal women in our country. It has been recognized that women are protected from CAD prior to the menopause. Statistics have showed tha...
Torsion of Non-Gravid Uterus with Myoma Presenting to Emergency with Shock
Abdominal pain is one of most frequently encountered complain in the emergency; poses a diagnostic challenge for the emergency physician as differential diagnosis ranges from benign to life threatening conditions. Histor...
Complicated Femur Fracture with Acute Respiratory Distress Syndrome Secondary to Fat Embolism Syndrome
Fat embolism (FE) is defined as a blockage of vasculature by fat globules that originate either from bone marrow or adipose tissue. It mainly affects the lungs, but can also affect the skin, retina, and central nervous s...