P1-478 Pre-hospital delay and predictors of mortality in patients presenting to emergency department with stroke: a developing Nation scenario

Background Stroke is one of the leading causes of death and disability in developed nations. Materials and Methods A prospective study was conducted to assess the factors influencing this delay in admission of acute stroke cases, in-hospital mortality was calculated and factors associated with mortality were looked for. Survival was calculated using Kaplan-Meier curve and Cox-proportional hazards model was constructed to identify independent predictors of inpatient mortality. Results Of 134 subjects studied, 73.4% were male with mean (SD) age of 53.8(18.0) years. Median delay in reaching hospital was 9 h and only 18 (13.4%) reached hospital within 3 h and 31(20.3%) reached within 6 h. Distances from hospital, referral, belief in myths and alternate medicine and low threat perception of symptoms of stroke were independent factors associated with delay in arrival. Living in city, day time onset, urgency shown by attendant, availability of transport and presence of family history were associated with early arrival. ICF rate has no relation with age (p=0.516), sex (p=0.460), number of episodes (0.795), underlying hypertension (p=0.905). Odds of diabetics dying were 12 times higher than non-diabetics. Inpatient mortality was also significantly higher in smokers compared with non-smokers (p=0.004), in patients with right-sided compared with left-sided hemiplegic (p=0.029) and who couldn9t afford computed tomography (CT) scan (p=0.007). Conclusion Majority of patients did not reach hospital early enough to receive thrombolytics and had high in-hospital mortality. Diabetes and smoking were independent predictors of in-hospital mortality.