Abstract
Treating ischemic stroke patients with recombinant tissue plasminogen activator (rtPA) no more
than 3 hours or 180 minutes after the stroke can increase the chance of recovery or improved condition. If, however, treatment is delayed, the potential outcome may be permanent disability or death. This descriptive
study was conducted with the objective of assessing time elapsed before treatment in ischemic stroke
patients and analyzing the factors influencing the amount of time elapsed before ischemic stroke patients
receive hospital treatment. The sample group was composed of 300 ischemic stroke patients treated at
Sanphasitthiprasong Hospital in the province of Ubon Ratchathani, Thailand. Data were collected from
November 2014 to February 2015. The following three sets of instruments were employed: 1) Demographic
Data Questionnaire; 2) Ischemic Stroke Evaluation Form and 3) Time to Treatment Evaluation Form. Data
were analyzed by descriptive statistics and the correlations by using Spearman’s correlation coefficient.
According to the research findings, 229 of the 300 ischemic stroke patients (76.3%) had pre-hospital
times of more than 180 minutes. The median pre-hospital time from the occurrence of stroke to hospital
arrival was equal to 302.5 min. The amount of time elapsed from arrival in the emergency room at
Sapphasitthiprasong Hospital until receipt of treatment (in-hospital time) was equal to 107.5 min. Therefore,
the median time from the initial presenting symptoms until treatment was equal to 590 min. Furthermore,
the pre-hospital time, the distance from the site of the incident to the hospital and the in-hospital
time from arrival until receiving laboratory test results were found to be positively correlated with the
pre-hospital time from the initial presenting symptoms until receipt of treatment (rs = 0.661, 0.185, 0.235,
p < 0.01). The severity of symptoms evaluated with National Institute of Health Stroke Scale (NIHSS)
scores was found to be negatively correlated with pre-hospital time (rs = - 0.129, p < 0.05).
In summary, most ischemic stroke patients within the boundaries of Ubon Ratchathani receive delayed
treatment in which the pre-hospital time has the highest correlation with receipt of treatment and
instructing patients, people at risk for ischemic stroke and their relatives. Moreover, the development of
an emergency medical service provision system and a hospital referral system that minimizes procedures
and time in transferring ischemic stroke patients is vital to helping ischemic stroke patients receive timely
treatment.
