PROSPECTIVE-STUDY OF REFERRAL DELAY IN A COHORT OF 519 ACUTE STROKE PATIENTS

OBJECTIVES: Development of new treatments at the acute phase of ischem ic stroke has modified the modalities of hospital referral for stroke patients. Because stroke is not considered a true emergency, acute tre atment within 6 hours of symptom onset may be proposed in only a few p atients. PATIENTS AND METHODS: A prospective study of stroke patients admitted to the Neurology Department of the University Hospital of Nan cy was conducted over a 3 year period establishing a new stroke regist ry. Data concerning the patient, stroke, follow-up, acute treatment an d time periods of the acute phase were systematically collected and an alyzed. RESULTS: We present here the analysis of the referral lime per iods for the first 519 patients. Hospitalization occurred within the f irst 24 hours (median 4 h) for 86% of the patients. Within the first s ix hours, 63% presented to the Emergency Department and 44% to the Neu rology Department with a mean in-hospital time of 2 hours. Age (p: 0.0 001), the use of Emergency services being more rapid. CONCLUSION: An e mergency policy for the management of stroke patients should consider the causes of delay of hospital referral, mainly the number of stages. Shortening delays is possible but requires further medical and public education. (C) 1998, Masson, Paris.