Prevalence and factors associated with pre-hospital delay among acute stroke patients at Mulago and Kiruddu national referral hospitals, Kampala: a cross-sectional study

BMC Neurology

Research

Mark Kaddumukasa¹  Elly Katabira¹  Irene Andia-Biraro¹  Keith Twirire Kakame²  Chris Burant³  Jane Nakibuuka⁴  Martha Sajatovic⁵  Nelson Mukiza⁶ 

[1] Department of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda;Department of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda;Mulago National Referral Hospital, P.O Box 7051, Kampala, Uganda;Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, TOMO, USA;Mulago National Referral Hospital, P.O Box 7051, Kampala, Uganda;Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center & Case Western Reserve University School of Medicine, 11100 Euclid Avenue, 44106, Cleveland, OH, USA;RhineCynth Advisory Limited, Kampala, Uganda;

关键词: Pre-hospital delay;    Stroke;    Acute stroke care;    Low and middle-income countries;   

DOI  :  10.1186/s12883-023-03413-1

 received in 2023-01-22, accepted in 2023-09-29,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDespite advancements in acute stroke care, acute stroke patients present late for care resulting in high mortality and poor functional outcomes. This study determined the prevalence of pre-hospital delay and associated factors among adult acute stroke patients in Uganda.MethodsIn a hospital based, cross-sectional study, one hundred and forty-three study participants with confirmed acute stroke presenting to the emergency units of Mulago and Kiruddu national referral hospitals were enrolled. Using an interviewer-administered questionnaire, details on sociodemographics, onset of stroke, arrival at the tertiary facility, health system and clinical factors were collected. Descriptive statistics and modified Poisson regression analyses were performed to determine factors associated with prehospital delay.ResultsAmong the 143 study participants, nearly two-thirds (79/146) had ischemic stroke while a third (59/143) had haemorrhagic stroke. The mean age was 59 years (SD 16) and 51.7% of acute stroke patients were males. Ninety one percent (130/143) presented to the emergency unit after 3 hours. The majority (124/143) reported visiting lower-level facilities prior to referral to the tertiary facility. Staying outside Kampala district (PR: 1.28 (1.22–1.34), p < 0.001), and using hired or government ambulance for transport to tertiary facility (PR: 1.17 (1.13–1.20), p < 0.001) were associated with pre-hospital delay.ConclusionsPrevalence of pre-hospital delay among acute stroke patients presenting to public tertiary hospitals in Uganda is very high. The causes of pre hospital delay should be further explored qualitatively. Efforts to reduce prehospital delay should include improving pre-hospital transport systems for stroke patients.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 7