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Factors Affecting Thrombolysis of Stroke in Emergency Department of a Tertiary Care Hospital

M. Mahammad Rafi , M Mahammad Rafi1 , Kingsly Robert Gnanadurai2 , C Sreekanth3

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Indian Journal of Emergency Medicine 5(3):p 175-181, July-September 2019. | DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.5319.4

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M. Mahammad Rafi, Kingsly Robert Gnanadurai, C. Sreekanth. Factors Affecting Thrombolysis of Stroke in Emergency Department of a Tertiary Care Hospital. Indian J Emerg Med. 2019;5(3):175-181.

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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.

Keywords: Stroke; Pre hospital; Thrombolysis

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Cite this article

M. Mahammad Rafi, Kingsly Robert Gnanadurai, C. Sreekanth. Factors Affecting Thrombolysis of Stroke in Emergency Department of a Tertiary Care Hospital. Indian J Emerg Med. 2019;5(3):175-181.

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DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.5319.4

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