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Of 2099 patients screened,adequate time data were available in 1159. Thirty-nine percent presented to the hospital 90 minutes or less after symptom onset and 59%within 3 hours.Early hospital arrival after stroke was greatly influenced by the type of first medical contact and,to a lesser degree,by the patient's location at the time of the stroke and the time of the day at which the stroke occurred.Hospital arrival was fastest in patients using 911 as their first medical contact(mean,155 minutes; median,84 minutes)vs their personal physician(mean,379 minutes,median,270 minutes;P<.0001)or a study hospital(mean,333 minutes;median,212 minutes; P<.0001).Time from symptom onset to arrival was longer for patients having the stroke at night compared with patients having a stroke in the morning (P<.05),in the afternoon(P<.01),or in the evening(P<.001).Time to hospital arrival was significantly longer for patients having the stroke at home than for patients having the stroke at work(P<.01)or in an unknown place (P<.05).Gender,age,race,and presence of brain hemorrhage had no significant effect.As many as 50%of patients with stroke arrive at the hospital within 3 hours of symptom onset.Our data indicate that strategies to increase the use of 911 systems may have a high yield with regard to recruitment into urgent treatment protocols for stroke. |
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