رابطه بين فاصله زماني شروع علايم سكته مغزي تا مراجعه به اورژانس با مشخصات جمعيت شناختي بيماران مبتلا به حوادث عروق مغزي

Relationship between the Time Interval between the Onset of Stroke Symptoms and Referral to the Emergency Department with Demographic Characteristics of Patients with Cerebrovascular

زﻣﯿﻨﻪ و ﻫﺪف: ﻣﺮاﺟﻌﻪ ﺑﻪ ﻣﻮﻗﻊ ﭘﺲ از اﺳﺘﺮوك و اﺳﺘﻔﺎده از درﻣﺎن ﻫﺎي ﻧﻮﯾﻦ ورﯾﺪي و ﮐﻨﺘﺮل ﻓﺸﺎرﺧﻮن ﺑﺎﻋﺚ ﺗﺴﺮﯾﻊ در ﺑﻬﺒﻮد ﻋﻼﯾﻢ ﭘﺲ از ﺳﮑﺘﻪ ﻣﻐﺰي ﻣﯽ ﺷﻮد. ﻟﺬا اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف راﺑﻄﻪ ﺑﯿﻦ ﻓﺎﺻﻠﻪ زﻣﺎﻧﯽ ﺷﺮوع ﻋﻼﯾﻢ ﺳﮑﺘﻪ ﻣﻐﺰي ﺗﺎ ﻣﺮاﺟﻌﻪ ﺑﻪ اورژاﻧﺲ ﺑﺎ ﻣﺸﺨﺼﺎت ﺟﻤﻌﯿﺖ ﺷﻨﺎﺧﺘﯽ ﺑﯿﻤﺎران ﻣﺒﺘﻼﺑﻪ ﺣﻮادث ﻋﺮوق ﻣﻐﺰي ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ اورژاﻧﺲ ﺑﯿﻤﺎرﺳﺘﺎن اﻣﺎم ﺧﻤﯿﻨﯽ (ره) اروﻣﯿﻪ اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روش ﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﺻﻮرت ﺗﻮﺻﯿﻔﯽ ﺗﺤﻠﯿﻠﯽ ﺑﺮ روي، 296 ﻧﻔﺮ از ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه، ﭘﺲ از وﻗﻮع اﺳﺘﺮوك ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن اﻣﺎم ﺧﻤﯿﻨﯽ (ره) اروﻣﯿﻪ در ﻧﯿﻤﺴﺎل اول ﺳﺎل 1397 ﺑﻪ روش ﺳﺮﺷﻤﺎري اﻧﺠﺎم ﺷﺪ. اﻃﻼﻋﺎت ﺑﺎ اﺳﺘﻔﺎده از ﭘﺮﺳﺸﻨﺎﻣﻪ ﺟﻤﻌﯿﺖ ﺷﻨﺎﺧﺘﯽ ﺟﻤﻊ آوري ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ ﺑﯿﻤﺎران 68/87±14/75 ﺳﺎل ﮐﻪ از ﻧﻈﺮ ﺟﻨﺲ 153 ﻧﻔﺮ (51/7 درﺻﺪ) ﻣﺬﮐﺮ و 143 ﻧﻔﺮ(48/3درﺻﺪ) ﻣﺆﻧﺚ ﺑﻮدﻧﺪ. ﻣﯿﺎﻧﮕﯿﻦ زﻣﺎن ﺷﺮوع ﻋﻼﯾﻢ ﺗﺎ ﻣﺮاﺟﻌﻪ ﺑﻪ اورژاﻧﺲ 36/21±4/4 ﺳﺎﻋﺖ، ﻣﯿﺎﻧﮕﯿﻦ زﻣﺎن ﻻزم ﺟﻬﺖ رﺳﯿﺪن ﺑﻪ اورژاﻧﺲ 35/98±2/48 دﻗﯿﻘ ﻣﯿﺎﻧﮕﯿﻦ ﺑﻌﺪ ﻣﺴﺎﻓﺖ ﺗﺎ زﻣﺎن رﺳﯿﺪن ﺑﻪ اورژاﻧﺲ 41/11±3/95 ﮐﯿﻠﻮﻣﺘﺮ ﺑﻮد. 291 ﻧﻔﺮ (98/3 درﺻﺪ) ﻧﻮع اﺳﺘﺮوك اﯾﺴﮑﻤﯿﮏ و در 5 ﻧﻔﺮ (1/7درﺻﺪ) هموراژﯾﮏ ﺑﻮد. ﺑﻌﺪ ﻣﺴﺎﻓﺖ، ﺳﻄﺢ ﺗﺤﺼﯿﻼت ﺑﯿﻤﺎر و ﻫﻤﺮاﻫﺎن وي و ﻧﺤﻮه اﻧﺘﻘﺎل ارﺗﺒﺎط ﻣﻌﻨ ﺎداري ﺑﺎ ﺗﺄﺧﯿﺮ در زﻣﺎن ﻣﺮاﺟﻌﻪ ﺑﻪ اورژاﻧﺲ ﺑﯿﻤﺎرﺳﺘﺎن داﺷﺘﻨﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: زﻣﺎن ﻣﺮاﺟﻌﻪ ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﺟﻬﺖ درﻣﺎن ﺑﯿﻤﺎران ﭘﺲ از ﺑﺮوز ﺳﮑﺘﻪ از ﻣﯿﺎﻧﮕﯿﻦ ﺑﺎﻻﯾﯽ ﺑﺮﺧﻮردار اﺳﺖ و ﻋﻮاﻣﻠﯽ ﭼﻮن ﻓﺎﺻﻠﻪ زﯾﺎد از ﻣﺮﮐﺰ درﻣﺎﻧﯽ، ﻧﺤﻮه اﻧﺘﻘﺎل ﺑﯿﻤﺎران، ﺳﻄﺢ ﺗﺤﺼﯿﻼت ﮐﻪ ﻣﯽ ﺗﻮاﻧﺪ ﻧﺸﺎن دﻫﻨﺪه ﻋﺪم آﮔﺎﻫﯽ ﮐﺎﻓﯽ در ﻣﻮرد ﻋﻼﯾﻢ ﺑﺎﻟﯿﻨﯽ ﺳﮑﺘﻪ ﺑﺎﺷﺪ در اﯾﻦ اﻣﺮ دﺧﺎﻟﺖ داﺷﺘﻨﺪ.

Background and Aim: Early referral after stroke and the use of modern intravenous therapies and blood pressure control accelerates the improvement of post-stroke symptoms. Therefore, this study was performed to investigate the relationship between the time interval between the onset of stroke symptoms and referral to the emergency department with demographic characteristics of patients with cerebrovascular accidents referred to the emergency department of Imam Khomeini Hospital in Urmia in the first half of 2018. Methods: This descriptive-analytical study was performed on 296 patients who had referred to the Imam Khomeini Hospital in Urmia in the first half of 2018 by census method. Data were collected using a demographic questionnaire. Results: In this study, the mean age of patients was 68.87±14.75 years, of which 153 (51.7%) were male and 143 (48.3%) were female. The mean time from the onset of symptoms to the emergency room was 36.21±4.04 hours, the mean time required to reach the emergency room was 35.98± 2.48 minutes and the mean distance to the time of arrival to the emergency room was 41.11±3.95 km. In this study, 291 patients (98.3%) had ischemic stroke and five patients (1.7%) had hemorrhagic stroke. Distance, level of education of both the patient and the patients' companions and the mode of transmission had a significant relationship with the delay in visiting the hospital emergency department. Conclusion: The results of the present study, showed that the time to refer to hospitals to treat patients after a stroke has a high average. Factors such as long distance to treatment centers, the way patients are transferred, the level of education which can actually indicate insufficient knowledge in clinical signs of stroke were involved in this affair.