Status and influencing factors of pre-hospital delay in young and middle-aged Chinese patients with acute ischemic stroke

Abstract

Objective: The purpose of this study was to investigate the status quo of prehospital delay in young and middle-aged AIS patients and analyze the main factors affecting prehospital delay in young and middle-aged AIS patients. Thus, it can provide reference for reducing prehospital delay in young and middle-aged AIS patients and promote secondary prevention of stroke.

Methods: This cross-sectional study was conducted from May 2023 to February 2024 using convenient sampling method, and included middle-aged and young ischemic stroke patients from two top three hospitals in Hunan Province. Through questionnaire survey, social support scale, health literacy scale and medical coping style scale were used to investigate.

Results: A total of 671 patients were investigated. According to the standard of 3 h from the onset of symptoms to the hospital, middle-aged and young stroke patients were divided into delayed group and non-delayed group. The results showed that 534 patients with pre-hospital delay occurred, with an incidence of 79.6%. Binary logistic regression analysis showed that the factors that extended the pre-hospital time of patients were: The onset place was at home (OR = 4.997, p = 0.011), the first symptoms were numbness and weakness of limbs (OR = 3.500, p = 0.027), avoidance coping style (OR = 1.298, p = 0.027) and submission coping style (OR = 1.721, p < 0.001). The factors that shorten the pre-hospital time of patients are: AIS was known at the time of onset (OR = 0.120, p = 0.001), the first symptoms were headache and vomiting (OR = 0.052, p < 0.001), disturbance of consciousness (OR = 0.087, p < 0.001), social support level (OR = 0.891, p = 0.001) and coping style (OR = 0.688, p < 0.001).

Conclusion: The incidence of pre-hospital delay in young and middle-aged ischemic stroke patients is high, and the current situation is not optimistic. Factors affecting pre-hospital delay in young and middle-aged AIS patients included location of onset, first symptoms, whether they knew that the onset was AIS, level of social support, health literacy, and coping style. In the future, these aspects can be considered to reduce the delayed development of AIS in young and middle-aged people before hospital and promote secondary prevention of stroke.

Keywords: acute ischemic stroke; coping styles; health literacy; pre-hospital delay; social support; young and middle-aged.