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Bajandouh WM, Alotaibi TN, Alharbi AR, Alzahrani SA, Alghamdi GA, Aleissi AH, Rashed A, Shatla M. Stroke Knowledge and Response Among the General Population in Saudi Arabia: A Population-Based Survey. Cureus 2024; 16:e65587. [PMID: 39192923 PMCID: PMC11349145 DOI: 10.7759/cureus.65587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2024] [Indexed: 08/29/2024] Open
Abstract
INTRODUCTION Stroke, a condition that disrupts brain function and can result in long-lasting clinical symptoms or death, remains a substantial global health concern. General awareness of stroke leads to a proper response to stroke, pursuit of medical treatment, and a better outcome. Our study aims to explore how the general Saudi Arabian population responds to stroke, investigate the relationship between stroke knowledge and appropriate actions, and identify the most relied upon medical information source about stroke among the public. By highlighting these aspects, we aspire to contribute to the development of effective stroke prevention and management strategies in Saudi Arabia. METHODOLOGY This descriptive, cross-sectional, web-based study was carried out across multiple regions in Saudi Arabia. Data collection involved a validated online questionnaire (STAT) in Arabic, targeting adults aged 18 and older. Data analysis was performed using SPSS software. RESULTS The study included 390 participants. Notable findings emerged regarding the recognition of stroke symptoms and the factors influencing this recognition. A substantial proportion of respondents correctly identified visual disturbances (55.9%), motor impairment (39.5%), cardiac symptoms (56.2%), sensory symptoms (32.8%), chest pain (62.6%), and arm weakness (36.7%) as indicators requiring immediate medical attention. However, there were lower correct response rates for symptoms such as sudden dizziness (22.8%), confusion (16.9%), difficulty understanding (27.9%), and urinary symptoms (26.9%). Older individuals and retirees generally scored higher in correctly identifying these symptoms. CONCLUSION Our study highlights a commendable level of awareness of certain stroke symptoms, such as visual disturbances and chest pain, among the general population of Saudi Arabia. Nonetheless, notable gaps remain in recognizing other symptoms, such as sudden dizziness and confusion. This identification gap presents a clear opportunity for targeted educational initiatives that are essential to improving public recognition of these symptoms. By addressing these gaps, we aim to enhance the response to stroke incidents, potentially improving outcomes and reducing morbidity rates.
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Affiliation(s)
- Wejdan M Bajandouh
- Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Turki N Alotaibi
- Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | | | - Saad A Alzahrani
- Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Ghidaa A Alghamdi
- Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Ahmad H Aleissi
- Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Asem Rashed
- Emergency Medicine, King Abdullah Medical City, Makkah, SAU
| | - Mokhtar Shatla
- Medicine, College of Medicine, Umm Al-Qura University, Makkah, SAU
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Dong J, Ma Y, Chen Y, Guo J, Zhang T, Yang T, Zhang H, Yan F, Han L. Prevalence and influencing factors of patient delay in stroke patients: a systematic review and meta-analysis. Neurosurg Rev 2024; 47:202. [PMID: 38700541 DOI: 10.1007/s10143-024-02436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 03/03/2024] [Accepted: 04/27/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Determine the prevalence and influencing factors of patient delay in stroke patients and explore variation in prevalence by country and delayed time. METHODS PubMed, The Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Weipu database, and Wanfang database were comprehensively searched for observational studies from inception to April, 2023. The pooled prevalence, odds ratio (OR), and 95% confidence intervals (CI) were calculated with Stata 16.0 software. RESULTS In total, 2721 articles were screened and data from 70 studies involving 85,468 subjects were used in meta-analysis. The pooled prevalence of patient delay in stroke patients was 59% (95% CI, 0.54-0.64). The estimates of pooled prevalence calculated for African, Asian, and European patient delay in stroke patients were 55% (0.29-0.81), 61% (0.56-0.66), and 49% (0.34-0.64).According to the patient delay time, the prevalence of 6 h, 5 h, 4.5 h, 3.5 h, 3 h and 2 h were 54% (0.47-0.61), 73% (0.61-0.86), 60% (0.49-0.71), 81% (0.68-0.93), 52% (0.42-0.62), 63% (0.19-1.07). Distance from the place of onset to the hospital > 10 km [OR=2.49, 95%CI (1.92, 3.24)], having medical insurance [OR = 0.45, 95%CI (0.26,0.80)], lack of stroke-related knowledge [OR = 1.56, 95%CI (1.08,2.26)], education level below junior high school [OR = 1.69, 95%CI (1.22,2.36)], non-emergency medical services (Non-EMS) [OR = 2.10, 95%CI (1.49,2.97)], living in rural areas [OR = 1.54, 95%CI (1.15,2.07)], disturbance of consciousness [OR = 0.60, 95%CI (0.39,0.93)], history of atrial fibrillation [OR = 0.53, 95%CI (0.47,0.59)], age ≥ 65 years [OR = 1.18, 95%CI (1.02,1.37)], National institutes of health stroke scale (NIHSS) ≤ 4 points [OR= 2.26, 95%CI (1.06,4.79)]were factors for patient delay in stroke patients. CONCLUSIONS The prevalence of patient delay in stroke patients is high, we should pay attention to the influencing factors of patient delay in stroke patients and provide a theoretical basis for shortening the treatment time of stroke patients.
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Affiliation(s)
- Jianhui Dong
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China
| | - Yuxia Ma
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China.
- School of First Clinical Medical, Lanzhou University, Lanzhou, Gansu, 730000, China.
| | - Yanru Chen
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China
| | - Jiali Guo
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China
| | - Tong Zhang
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China
| | - Tingting Yang
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China
| | - Hongyan Zhang
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu, 730030, China
| | - Fanghong Yan
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China
| | - Lin Han
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, China.
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu, 730030, China.
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Pantoja-Ruiz C, Porto F, Parra-Artunduaga M, Omaña-Alvarez L, Coral J, Rosselli D. Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011-2019. Neuroepidemiology 2023; 57:170-175. [PMID: 37454654 DOI: 10.1159/000529794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/13/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Treatment of stroke is time-dependent and it challenges patients' social and demographic context for timely consultation and effective access to reperfusion therapies. OBJECTIVE The objective of this study was to relate indicators of social position to cardiovascular risk factors, time of arrival, access to reperfusion therapy, and mortality in the setting of acute stroke. METHODS A retrospective analysis of patients with a diagnosis of ischaemic stroke in a referral hospital in Bogotá was performed. A simple random sample with a 5% margin of error and 95% confidence interval was selected. Patients were characterised according to educational level, place of origin, marital status, occupation, duration of symptoms before consultation, cardiovascular risk factors, access to reperfusion therapy, and mortality during hospitalisation. RESULTS 558 patients were included with a slight predominance of women. Diagnosis of diabetes was more common in women and smoking in men (n = 68, 28.4% vs. n = 51, 15.9%; p = 0.0004). Rural origin was associated with higher prevalence of hypertension, diabetes, and dyslipidaemia (hypertension n = 45, 73.8% vs. n = 282, 57.4%; p = 0.007; diabetes n = 20, 33.3% vs. 109, 19.5%; p = 0.02; dyslipidaemia n = 19, 32.7% vs. n = 93, 18.9%; p = 0.02). Mortality was higher in rural patients (n = 8, 14.2% vs. n = 30, 6.1%; p = 0.03). Lower schooling was associated with higher frequency of hypertension and dyslipidaemia (hypertension n = 152, 76.0% vs. n = 94, 46.3%; p ≤ 0.0001; dyslipidaemia n = 56, 28% vs. n = 35, 17.0%; p = 0.009) as well as with late consultation (n = 30, 15% vs. n = 59, 28.7%; p = 0.0011) and lower probability of accessing reperfusion therapy (n = 12, 6% vs. n = 45, 22%; p ≤ 0.0001). Formal employment was associated with a visit to the emergency department in less than 3 h (n = 50, 25.2% vs. n = 58, 18%, p = 0.04 and a higher probability of accessing reperfusion therapy (n = 35, 17.6% vs. n = 33, 10.2%; p = 0.01). Finally, living in a household with a stratum higher than 3 was associated with a consultation before 3 h (n = 77, 25.5% vs. n = 39, 15.6%; p = 0.004) and a higher probability of reperfusion therapy (n = 57, 18.9% vs. n = 13, 5.2%; p ≤ 0.0001). CONCLUSION Indicators of socio-economic status are related to mortality, consultation time, and access to reperfusion therapy. Mortality and reperfusion therapy are inequitably distributed and, therefore, more attention needs to be directed to the cause of these disparities in order to reduce the access gap in the context of acute stroke in Bogotá.
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Affiliation(s)
- Camila Pantoja-Ruiz
- Department of Neurology, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Felipe Porto
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Juliana Coral
- Department of Neurology, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
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Hamdan M, Yang X, Mavura M, Saleh M, Kannani G, Haonan K, Al-Danakh A, Zhaohui X, Zezhong G, Hyokju R, Amado B, Yanying R, Xin C. Factors associated with delayed reporting for surgical care among patients with surgical acute abdomen attended at Muhimbili National Hospital: Tanzania. BMC Gastroenterol 2023; 23:59. [PMID: 36890435 PMCID: PMC9996925 DOI: 10.1186/s12876-023-02659-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/24/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Surgical acute abdomen is a sudden onset of severe abdominal symptoms (pain, vomiting, constipation etc.) indicative of a possible life-threatening intra-abdominal pathology, with most cases requiring immediate surgical intervention. Most studies from developing countries have focused on complications related to delayed diagnosis of specific abdominal problems like intestinal obstruction or acute appendicitis and only a few studies have assessed factors related to the delay in patients with acute abdomen. This study focused on the time from the onset of a surgical acute abdomen to presentation to determine factors that led to delayed reporting among these patients at the Muhimbili National Hospital (MNH) and aimed to close the knowledge gap on the incidence, presentation, etiology, and death rates for acute abdomen in Tanzania. METHODS We conducted a descriptive cross-sectional study at MNH, Tanzania. Patients with a clinical diagnosis of the surgical acute abdomen were consecutively enrolled in the study over a period of 6 months and data on the onset of symptoms, time of presentation to the hospital, and events during the illness were collected. RESULTS Age was significantly associated with delayed hospital presentation, with older groups presenting later than younger ones. Informal education and being uneducated were factors contributing to delayed presentation, while educated groups presented early, albeit the difference was statistically insignificant (p = 0.121). Patients working in the government sector had the lowest percentage of delayed presentation compared to those in the private sector and self-employed individuals, however, the difference was statistically insignificant. Family and cohabiting individuals showed late presentation (p = 0.03). Deficiencies in health care staff on duty, unfamiliarity with the medical facilities, and low experience in dealing with emergency cases were associated with the factors for delayed surgical care among patients. Delays in the presentation to the hospital increased mortality and morbidity, especially among patients who needed emergency surgical care. CONCLUSION Delayed reporting for surgical care among patients with surgical acute abdomen in underdeveloped countries like Tanzania is often not due to a single reason. The causes are distributed across several levels including the patient's age and family, deficiency in medical staff on duty and lack of experience in dealing with emergency cases, educational level, working sectors, socioeconomic and sociocultural status of the country.
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Affiliation(s)
- Maryam Hamdan
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Xu Yang
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - M Mavura
- Department of General Surgery, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania
| | - Mohammed Saleh
- Department allied, Health Science Zanzibar, Zanzibar, Tanzania
| | - George Kannani
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Kang Haonan
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Abdullah Al-Danakh
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xu Zhaohui
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Gong Zezhong
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Ri Hyokju
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Boureima Amado
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Ren Yanying
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China
| | - Chen Xin
- Department of Hernia and Colorectal Surgery, Second Hospital of Dalian Medical University, Dalian, China.
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Alkhotani A, Alharbi Y, Alghamdi H, Alshareef H, Abdulmuttalib JA, Alsulami A, Alharbi A. Time Window for Acute Stroke Treatment: Current Practice in King Abdullah Medical City Specialist Hospital in Makkah, Saudi Arabia. Cureus 2022; 14:e28878. [PMID: 36225413 PMCID: PMC9541426 DOI: 10.7759/cureus.28878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Stroke has become one of the most severe causes of long-term neurological impairment and disability and is considered one of the leading causes of mortality worldwide. This study aimed to determine time delays in stroke patients from symptoms onset to treatment with tissue plasminogen activator (tPA) initiation in King Abdullah Medical City Specialist Hospital, Makkah, Saudi Arabia. Patients and methods We reviewed 81 patients who suffered from acute stroke. The data were collected from patients’ electronic and paper files. Patients were divided into two main categories based on interval time from recognition of symptoms to tPA treatment. Patients were divided into early treatment, if the duration was less than or equal to 120 minutes, and delayed treatment, if the interval time was more than 120 minutes. Results Nearly two-thirds (64.2%) were males, and more than half (5.6%) were in the older age group (>65 years). Patients who underwent thrombectomy were 7.4%. The mean value of the National Institutes of Health Stroke Scale (NIHSS) score was 10.7 (SD: 7.14). The mean time from symptoms onset to arrival at the hospital was 82.4 (SD: 44.1) minutes, while the total time from recognition of symptoms to tPA treatment was 154 (SD: 50.8) minutes. The prevalence of patients with delayed treatment was 72.8%, and the rest were assumed to have early treatment (27.2%). None of the socio-demographic variables were predicted to influence delayed treatment. Conclusion A significant number of patients were delayed in treatment. Patients' socio-demographic data and NIHSS scores seem to have no significant effect on delayed treatment. Further research is needed to establish the delay in time for pre-hospital and in-hospital treatment of stroke patients.
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