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Factors Influencing the Pre- and In-Hospital Management of Acute Stroke – Data from a Greek Tertiary Care Hospital

In a prospective observational study, data on pre- and in-hospital management of acute stroke patients were collected from 100 consecutive patients admitted to the emergency room (ER) of Papageorgiou Hospital, a tertiary health care facility in Thessaloniki, Greece. Public emergency services were used by 58% of the patients, and 42% were brought by their relatives. 27% of the patients arrived within 1.5 h, 45% within 3 h, and 71% within 6 h from symptom onset. The median interval from ER arrival to examination by a board-certified neurologist was 20 min (range 5–40 min). Time from ER arrival until brain CT scan ranged from 17 min to 28 h, with a median of 1.7 h. The majority (57%) of acute stroke patients reached hospital and received adequate diagnostic and treatment within 6 h, and approximately 30% even within 3 h from symptom onset. Thus, and in contrast to widespread perception, there is a time window for hyper-acute stroke treatment in Greek public hospitals. However, the fraction of patients eligible for acute treatment may be increased by shortening both the interval from symptom onset to hospital arrival, and also the door-to-CT interval.