急性缺血性腦中風病患延遲到醫相關因素之探討

Factors Associated with Hospital Arrival Delays after Acute Ischemic Strokes

蔡宜秀(Yi-Hsiu Tsai) ； 孫明輝(Ming-Hui Sun) ； 陳秋美(Chiu-Mei Chen) ； 郭憲文(Hsien-Wen Kuo) ； 洪麗珍(Li-Chen Hung)

《Mid-Taiwan Journal of Medicine》 8卷s_1期 (2003/11) Pp. s36-s42

https://doi.org/10.6558/MTJM.2003.8(s_1).6

摘要

目的 探討影響急性梗塞性中風患者延遲到醫治療之相關因素。
方法 利用前瞻式研究設計針對477位中風患者為對象，以其發作後到醫時間是否超過3小時當作切點（cut-off point），分為及時到醫者（26.4%）及延遲到醫者（73.6%）兩組。由醫院個案管理師會談後收集相關資料，來源包括病歷記錄、病人及其家屬。
結果 中風病患之性別、年齡、中風次數與其是否有延遲到醫並無顯著性之相關，以logistic複迴歸分析延遲到醫之主要影響因素包括：意識清醒者（調整後勝算比(AOR)=3.1）、無噁心嘔吐者(AOR=2.4)、選擇門診就醫(AOR=7.7)、小洞性梗塞者(AOR=3.1)及有其他病因者(AOR=2.7)等變項。
結論 提高民眾對中風個案徵兆嚴重性的認知及發作緊急就醫的警覺性，以減少中風患者延遲到醫的時機。

關鍵字

急性 ； 延遲 ； 到醫 ； 缺血性腦中風

並列摘要

Objectives. This study was designed to investigate the factors associated with hospital arrival delays after stroke attacks.
Methods. Four hundred seventy-seven patients with ischemic strokes were enrolled in this prospective study. Patients were divided into either an “On-time” group (26.4%, within 3 hours) or a “Delay” group (73.6 over 3 hours) according to their hospital arrival times. Data were collected from medical records, patients and family members by a structured questionnaire.
Results. Variables including gender, age and recurrent status did not significantly affect the delay in hospital arrival. Multiple logistic regression analysis showed that the significant factors which affected hospital arrival times were consciousness (adjusted odds ratio, AOR=3.1), absence of nausea or vomiting symptoms (AOR=2.4), outpatient status (AOR=7.7), small-vessel occlusion (AOR=3.1) and other factors (AOR=2.7).
Conclusions. A reduction in hospital arrival delays can be achieved by increasing public awareness of the seriousness of stroke symptoms and the need to seek medical or other attention promptly after stroke onset.

並列關鍵字

acute ； delay ； hospital arrival ； ischemic stroke