Abstract
FACTORS CAUSING DELAY IN PRESENTATION OF STROKE PATIENTS IN MEDICAL COLLEGE CATERING TO THE POPULATION OF SUBHIMALYAN REGION OF RURAL INDIA

Dhiraj Kapoor, Pankaj Kumar*, Shivani Sandhu, Dinesh Kumar, Ashish Sharma, Sanjay Kashyap

ABSTRACT

Objective: Various trials, show that treatment of ischemic stroke within the first 90 minutes of onset increased the odds of a favourable outcome by 2.8 fold, in the 91 to 180-minute window by 1.6 fold, and in the 181 to 270-minute window by 1.4 fold, while treatment in the 271 to 360-minute window did not improve outcome in a statistically significant way. So, the sooner tPA is given to patients, the greater the benefit is. As effective treatment for acute stroke is available, it is important to analyze the factors that are responsible for delay. If such factors are identified then strategies can be planned to expediate the arrival time at the hospital within the therapeutic window. Various Indian studies have been conducted in the urban part, but no such study has been done in rural and hilly region like Himachal Pradesh, where the demographic, social, behavioural and perceptual factors are different. Materials And Methods: So an observational cross-sectional hospital based study was conducted to look for the factors responsible for the delay in presentation of patients with acute stroke admitted in Dr. RPGMC (Tanda) H.P for a period of 12 months. Result And Conclusion: The factors which were found responsible for delayed presentation to hospital were: distance from home to nearest road, distance from nearest road to hospital, visit to local doctor, time of 1st medical contact, time taken by local doctor to refer, low threat perception of patients/ attendants, less concern about symptoms, perception of symptoms as non serious. Measures to reduce the delay in arrival of acute stroke patients to specialist will require careful education among the profession and the public of the importance of prompt transfer.

Keywords: .


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