Delay in hospital arrival and determinate factors among acute stroke Patients at Yekatit-12 Hospital Medical Collage, Ethiopia: Unmatched case-control study

Abstract

<title>Abstract</title> <bold>Background:</bold> Stroke is a rapidly developing clinical sign of focal or global disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin. prehospital delay in stroke is the time between the onset of symptoms to admission to the Hospital. <bold>Objective:</bold> To determine factors associated with delayed arrival of an adult at the hospital following an acute stroke <bold>Method:</bold>An unmatched case–control study was conducted from September 2021 to November 2023 at Yekatit 12 Hospital Medical College. Descriptive statistics were used to describe the study variables. Bivariable and multivariable logistic regression analyses were used to identify the determinants of delayed presentation of stroke to the hospital. <bold>Result:</bold> Out of 83 cases (presenting after four hours) and 166 controls (presenting within four or fewer hours) of an acute stroke patient who was admitted to the emergency department; The duration of symptoms from the onset of stroke to presentation to the hospital, the median time for cases was 24 hours (IQR, 12 hr) and in control the median time was 2 hours. The study found Age 60 or less (AOR 1.75, 95% CI 1–3.09, p&lt;0.05), living outside of Addis Ababa (AOR 3.55, 95% CI 1.33-9.46, p&lt;0.011), onset of stroke occurring at night (AOR 1.75, 95% CI 1–3.1, p&lt;0.05) and not having health insurance (AOR 0.43, 95% CI 0.23- 0.8,p&lt; 0.007) were identified as predicting factors of late presentation in acute stroke patients. <bold>Conclusion:</bold> This study highlights key factors affecting delayed presentation of acute stroke patients. Specifically, age, place of residence, health insurance, and stroke onset time significantly influence the timeliness of seeking medical care. Improving the modifiable factors through public education can enhance early thrombolytic action, improve the overall prognosis of stroke patients, and avoid delays in the early hospital admission of these patients.