Time delays for admission and treatment of acute strokes in a stroke unit.

Background and objective:This observational study describes the time delays involved in the emergency treatment of acute strokes admitted for treatmen t in the acute stroke unit of the Landesnervenklinik tugging, Austria. The aim was to define avoidable delays in the prehospital and intrahospital pha se. Patients and methods: 261 stroke patients were included conscutively within the one-year study period (September 1996 until September 1997). Minute-by -minute reconstruction of events starting from the first symptoms to the fi rst therapeutic application within the stroke unit was performed for every stroke patient by a neurologist during or immediately after treatment. Results: Time delays are predominantly in the prehospital phase. Only 20.5% are admitted within 120 minutes after noticing first symptoms. Public regi stration time was 42 +/- 212 minutes. In the intrahospital phase, the mean door-to-drug-time was 50 +/- 28 minutes (including CT). In 25% of the patie nts, adequate treatment of acute stroke was started within 35 minutes after the patient's arriving at: the hospital. In 92% cerebral computed tomograp hy was performed before treatment was started. Conclusions: This study shows the necessity for continuing efforts to incre ase public awareness for immediate hospitalisation after stroke in order to achieve a higher rate of urgent and direct admission to a stroke unit.