TITLE:
Recognition of Warning Signs by the Patient with Ischemic Stroke and Impact on Emergency Department Admission Times
AUTHORS:
Nga Nomo Serge, Kuitchet Aristide, Iroume Cristella, Djomo Tamchom, Chewa Gisèle, Hubel Kenne, Jemea Bonaventure, Nkoumou Samson, Pierre René Binyom, Binam Fidèle
KEYWORDS:
Warning Signs, Ischemic Stroke, Emergencies
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.9 No.4,
October
28,
2021
ABSTRACT: The general objective of this study was to assess
the impact of the recognition of warning, signs of ischemic stroke, on the
reduction of emergency admission times and the improvement of the prognosis of
the patient suffering from ischemic stroke in the emergency department of the
Yaounde central hospital. Methods: This was a prospective study with a descriptive and analytical aim
carried out in the medical emergency department of the central hospital of
Yaounde over a period of 3 months, going from October to December 2020. All
patients admitted to emergency departement, during this period, for a diagnosis
of ischemic stroke confirmed by a brain CT scan were included in the study. The
data was collected on a survey sheet divided into 3 sections: the patient, the
assessment of his knowledge and his reaction to the stroke. The variables
studied were socio-demographic data, cardiovascular risk factors and warning
signs of stroke. Data analysis was conducted with Census and Survey Processing
System (CSPRO). Results: During the study period, 62 patients met the
inclusion criteria. Adults under 50 (41.94%) were the most represented age
group. The mean age of the patients was 52.3 years with ranges ranging from 36
to 82 years. The sex ratio was 1.38 in favor of women. The most common unmodifiable
cardiovascular risk factor was age over 55 years 44%. High blood pressure 61%
was the most common modifiable risk factor. More than half of the study
population had no knowledge of the warning signs of ischemic stroke. The most
well-known warning sign was 40% mouth deformation. The anamnesis noted that the
weakness of the hemibody, the limb or the leg was found in our cohort in 77% of
cases, followed by balance disorder (73%) and speech disorder (50%). The main
associated sign was asthenia 32%. Direct admission to hospital through the
emergency department was the first call for alert 58%, followed by self-medication
32% and seeking help from a family member 31%. The emergency department
admission time was over 4 hours 30 minutes in more than half of the cases. Conclusion: Ischemic stroke is an important cause of death in sub-Saharan Africa in the
acute phase. Information, education and communication about the warning signs
of ischemic stroke reduce the time to emergency room visits and improve the
prognosis of these patients.