Neurological Sciences

, Volume 34, Issue 4, pp 449–455 | Cite as

What is still missing in acute-phase treatment of stroke: a prospective observational study

  • Sara Mazzucco
  • Giulia Turri
  • Rina Mirandola
  • Paolo Bovi
  • Giulia Bisoffi
  • Verona Hospital Stroke Study Group
Original Article

Abstract

Early recognition of stroke symptoms and activation of emergency medical service (EMS) positively affects prognosis after a stroke. To assess stroke awareness among stroke patients and medical personnel in the catchment area of Verona Hospital and how it affects stroke care, we prospectively studied timing of acute stroke care in relation to patients’ characteristics. Patients admitted to Medical Departments of Verona University Hospital between January 1st and December 31st 2009 with a diagnosis of TIA or stroke were enrolled. Outcome measures were: time between (i) symptoms onset and hospital arrival, (ii) hospital arrival and brain CT scan, blood examination, ECG and neurological evaluation. The following patient/event characteristics were also collected: means of hospital arrival, sex, age, degree of disability, type of event (first or recurrent) and acute-phase treatment. Of 578 patients providing complete information, 60 % arrived to the emergency department with the EMS (EMS+ group), while 40 % arrived on their own (EMS−). EMS+ group was older than EMS− (mean age 76.2, SD 13.2, vs. 72.3, SD 13, respectively), displayed more severe symptoms (mRS 4 vs. 2) and shorter time interval between symptoms onset and hospital arrival, hospital arrival and CT scan, ECG, laboratory tests and neurological evaluation (p < 0.0001); 22 % of the EMS+ patients were stroke recurrences versus 29 % of the EMS− (p = 0.058); 85 % of thrombolised patients were EMS+. We conclude that there is a lack of awareness of stroke symptoms and risks of recurrence even among patients who already had a stroke and among medical personnel.

Keywords

Stroke Stroke awareness Thrombolysis Emergency medical service Educational programs 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Sara Mazzucco
    • 1
  • Giulia Turri
    • 1
  • Rina Mirandola
    • 2
  • Paolo Bovi
    • 3
  • Giulia Bisoffi
    • 2
  • Verona Hospital Stroke Study Group
  1. 1.Department of Neurological, Neuropsychological, Morphological and Motor Sciences, Section of Clinical NeurologyUniversity of VeronaVeronaItaly
  2. 2.Biostatistical UnitUniversity Hospital of VeronaVeronaItaly
  3. 3.Department of Neurosciences, Stroke UnitUniversity Hospital of VeronaVeronaItaly

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