Time of hospital presentation after stroke. A multicenter study in north-east Italy

Given the current orientation towards the early treatment of stroke, this multicenter study was carried out in Northeast Italy in order to examine the times between stroke onset and hospital admission, and the possible factors leading to a lengthening of such times. An analysis was made of 348 patients, 79.8% of whom had experienced an ischemic cerebral infarct. Arrival times were not significantly modified by the distance from hospital, age, family cohabitation, socio-cultural level, population density or the geographical location of the Center. Sixty percent of the ischemic stroke cases arrived at the Emergency Department within three hours, and 80% within six hours; the hemorrhagic cases arrived earlier, 100% of them by the tenth hour. The duration of stay in the Emergency Department did not vary in relation to the severity or type of stroke. Greater severity, a reduced level of awareness and daytime onset led to a moderately significant reduction in presentation times. In conclusion, the majority of patients arrived sufficiently quickly to be treated within the ''therapeutic window''; nevertheless, an information campaign may be useful in accelerating the hospital presentation of the albeit limited number of cases who arrive late.