Acute stroke onset to presentation and computed tomography in a Tertiary Hospital, north central Nigeria

Abstract

Background: The burden of stroke is immense. Timely presentation and interventional treatment options have shown promising outcomes in acute stroke patients. This is a luxury that the developing world is yet to see being practiced routinely. Patients need to present early enough for targeted treatment to be instituted, this however, is yet to be achieved in many parts of the developing world.

Objective: To study the duration from acute stroke onset to presentation to the hospital and the time it takes patients to get a brain Computed Tomography (CT) scan with a view to relating it with patient outcome.

Methods: This study was conducted between April 2014 and September 2015 on acute stroke patients that presented at the emergency unit and had CT within one week of ictus. Duration from acute stroke onset to presentation at the hospital and duration from ictus to performing CT scan were noted, this was related with the modified Rankin scale(mRS) assessment outcome. Collected data were analyzed with Statistical Package for Social Sciences (SPSS) version 20.0 and statistical level  of significance was set at P ≤ 0.05.

Results: One hundred and fifty-three acute stroke patients were observed. Only 2 patients presented less than 3 hours from onset of stroke and no patient had a CT at less than 3 hours from ictus. The relationship between sex of the patient and duration from stroke onset to presentation and duration to CT were significant, while relationship between type of stroke  and patient mRS outcome  assessment were not significant in both categories of duration. 

Conclusion: Majority of acute stroke patients present rather late to the  hospital. A lot still needs to be done to improve  public education about acute stroke care and the importance of early presentation.