Oral Sessions. Wednesday 27, May 2009

医学
作者
Nicola Paul,Arvind Chandratheva,Daniel Lasserson,Peter M. Rothwell,Andrew M. Penn,M Montague,M Bamford,K Maclure,Thanh G. Phan,Helen Psihogios,Lauren Sanders,David Ramsay,KokSheik Wong,Velandai Srikanth,Lars Marquardt,Olivia Geraghty,Julia Ferrari,Michael Knoflach,Stefan Kiechl,Johann Willeit,Stefan Schnabl,Leonhard Seyfang,Wilfried Lang,Áine Merwick,Shelagh B. Coutts,Hakan Ay,Francisco Purroy,David Calvet,Andrew M. Demchuk,Michael B. Giles,Orla C. Sheehan,Jean‐Marc Olivot,Gregory W. Albers,Jeffrey L. Saver,Karen L. Furie,Jean‐Louis Mas,Peter J. Kelly
出处
期刊:Cerebrovascular Diseases [Karger Publishers]
卷期号:27 (6): 1-27
标识
DOI:10.1159/000221772
摘要

Background: Many countries have instigated public education campaigns to improve awareness of TIA and stroke and the need to seek medical attention immediately.In the UK, since 2004 there has been much media coverage of research on the high risk of major stroke after TIA or minor stroke and the Stroke Association launched a campaign to publicise the FAST test in 2006.However there are no published data on the impact of these developments on delays to presentation in people with TIA and minor stroke.Methods: We prospectively recorded delays to presentation of consecutive patients with incident or recurrent TIA or stroke in a population-based study in Oxfordshire, UK, from 1st April 2002, using multiple methods of case ascertainment (Oxford Vascular Study).Minor stroke was defined as NIHSS ≤5 at first assessment.Results: Of 1390 patients (638 TIA, 752 minor stroke), 299 (47%) with TIA and 346 (46%) with minor stroke sought medical attention within 3 hours and 427 (67%) with TIA and 556 (74%) with minor stroke sought attention within 24 hours.There was no significant reduction in delays to seeking medical attention over the seven year study period.Most patients first sought attention from primary care (TIA 77%, minor stroke 72%).Correct recognition of symptoms (31% of patients) was associated with less delay in TIA patients (2.33 vs 7.25 hours), as was age ≥60 yrs, presence of weakness or speech disturbance, and duration of event ≥60 minutes (all p<0.001).Delays were greater at the weekends than weekdays (25.13 vs 3.00 hours, p<0.001).Conclusions: Many patients with TIA or minor stroke delay seeking medical attention.Patients at higher predicted risk do present more quickly as do those who correctly recognise their symptoms, but public education in UK has had little impact so far on delays to calling for medical attention.2 Acute cerebrovascular events (ACE): TIA and minor strokes

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