Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 28:41:79.
doi: 10.11604/pamj.2022.41.79.30191. eCollection 2022.

Pre-hospital delay in patients with ischemic stroke in the Fann Teaching Hospital, Dakar, Senegal in 2020

Michel-Arnaud Saphou Damon  1 , Anna Modji Basse  1 , Adjaratou Dieynabou Sow  1 , Prisca-Rolande Bassole  2 , Marième-Soda Diop-Sene  1 , Franck-Ladys Banzouzi  1 , Mame Maïmouna Diaw Santos  1 , Kamadore Toure  1   3
Affiliations

Pre-hospital delay in patients with ischemic stroke in the Fann Teaching Hospital, Dakar, Senegal in 2020

Michel-Arnaud Saphou Damon et al. Pan Afr Med J. .

Abstract

Introduction: stroke is a cerebrovascular disease. Early reperfusion in neurovascular units can reduce its morbidity and mortality. Even when neurovascular units exist, patients usually arrive late in the emergency department. to the purpose of this study was to determine prehospital delay in patients with acute ischemic stroke and associated factors.

Methods: we conducted a retrospective cross-sectional study in the neurology department of the Fann University Hospital in Dakar from January 1s t to June 30th, 2020. We included patients younger than 80 years seen in the emergency unit for ischemic stroke. The median time to presentation was calculated based on the time of stroke onset and that of arrival at the hospital. Multivariate analysis was used to determine factors associated with prehospital delay.

Results: a total of 56 patients were enrolled, among whom 58.6% arrived at the hospital in less than 3 hours. Of them, 37.5% presented to a level 3 or 4 hospital first. Less than 34% of our patient presented to a level 2-3 hospital in less than 3 hours. Based on bi- and multivariate analysis, being married (OR = 7.2 [CI à 95%: 1.5 - 35.8]), being a female (OR = 5.5 [CI à 95%: 1.5 - 19.8]) and having stroke during week days (OR = 4.3 [CI à 95%: 1.3-13.9]) were associated with prehospital delay.

Conclusion: most of our patients arrived late at a level 2 or 3 hospital. Being a married woman increased the risk of late arrival. This study highlights the importance of improving awareness in order to increase the proportion of patients potentially eligible for revascularization.

Keywords: Pre-hospital delay; acute ischemic stroke; neurovascular unit; sub-Saharan Africa.

PubMed Disclaimer

Figures

Figure 1
Figure 1
patient distribution by time of stroke onset
Figure 2
Figure 2
breakdown of patients according to presentation time brackets in a level 2-3 structure
See this image and copyright information in PMC

References

    1. World Health Organization ICD-11 for mortality and morbidity statistics. 2018.
    1. World Health Organization The top 10 causes of death. Accesed December 9th 2020.
    1. Ralph LS, Scott EK, Joseph PB, Louis RC, Buddy CJJ, Antonio C, et al. An updated definition of stroke for the 21st century: statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013 Jul;44(7):2064–89. - PMC - PubMed
    1. Alexander PC, Ankur T, Mahim IQ, Harri J, Alun HD. The definition of stroke. J R Soc Med. 2017 Jan;110(1):9–12. - PMC - PubMed
    1. Touré K, Sawadogo AA, Sow A, Basse A, Diagne NS, Diop MS, et al. Mortalité des patients hospitalisés pour AVC ischémique en neurologie au Chu de Fann à Dakar. Neurologie Psychiatrie Gériatrie (NPG) 2017 Aug;17(100):230–4.