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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(11): 869-874
DOI: 10.1590/0004-282X20160142
ARTICLES

Perception of stroke symptoms and utilization of emergency medical services

Percepción de los síntomas del accidente cerebrovascular y utilización de los servicios de emergencias médicos
Maximiliano A. Hawkes
1   Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Instituto de Investigación Neurológica Raúl Carrea, Buenos Aires, Argentina.
,
Mauricio F. Farez
1   Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Instituto de Investigación Neurológica Raúl Carrea, Buenos Aires, Argentina.
,
Ismael L. Calandri
1   Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Instituto de Investigación Neurológica Raúl Carrea, Buenos Aires, Argentina.
,
Sebastián F. Ameriso
1   Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Instituto de Investigación Neurológica Raúl Carrea, Buenos Aires, Argentina.
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ABSTRACT

Lack of stroke awareness and slow activation of emergency medical services (EMS) are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population.

Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis.

Results Seventy patients (75%) arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02). Nineteen patients (20%) were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001).

Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

RESUMO

La falta de reconocimiento de los síntomas del accidente cerebrovascular (ACV) y la lenta activación de los servicios de emergencias médicos (SEM) son causas frecuentes de demoras en el arribo hospitalario. Nuestro objetivo fue evaluar ambas variables en nuestra población.

Métodos Revisión de registros hospitalarios y entrevista telefónica estructurada de 100 pacientes consecutivos internados por ACV. El análisis estadístico se realizó mediante un modelo de regresión logística multivariada por pasos.

Resultados Setenta pacientes (75%) arribaron al hospital luego de 4.5 horas del comienzo de los síntomas. El uso de los SEM no mejoró los tiempos de arribo al hospital (p < 0.02). Inicialmente, 19 pacientes (20%) recibieron un diagnóstico erróneo. Dieciocho de ellos fueron evaluados por médicos no neurólogos. (p < 0.001).

Conclusiones El reconocimiento de los síntomas de ACV en nuestra población fue bajo. El uso de los SEM no mejoró los tiempos de arribo hospitalario y la no utilización de los mismos se asoció con el correcto reconocimiento de los síntomas por parte de los pacientes. La proporción de diagnósticos erróneos fue preocupante, fundamentalmente entre médicos no neurólogos.

stroke - emergency medical system
accidente cerebrovascular - servicios de emergencias médico


Publication History

Received: 15 March 2016
Received: 05 June 2016

Accepted: 12 July 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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