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Roadblock in Treating Stroke Symptoms

Patients May Misjudge Severity of Symptoms, Delaying Treatment
By
WebMD Health News
Reviewed by Louise Chang, MD

March 23, 2006 -- New research shows why some people delay seeking treatment for stroke symptoms.

Those patients may size up their symptoms and wrongly decide their problem isn't urgent enough to get emergency care. That may be a dangerous mistake.

So says a study of 209 patients hospitalized for ischemic stroke, the most common type of stroke. In ischemic stroke, blood flow to the brain is blocked. Clot-busting drugs can help, but those drugs must be given within the first few hours after symptoms start.

The new study, published online in Stroke, shows that patients' attitudes about their symptoms -- and help from bystanders -- affected how quickly patients sought medical care.

Stroke is the No. 3 cause of death for American men and women, according to the CDC. Stroke is also a major cause of disability.

Stroke Survivors Interviewed

All of the patients were treated at the same public hospital in Israel. The researchers included Lori Mandelzweig, PhD, of Sheba Medical Center in Tel Hashomer, Israel.

The patients were interviewed two to 10 days after being hospitalized for ischemic stroke. If their condition prevented interviews, patients' family members were interviewed.

The interviewers asked how much time passed from the start of stroke symptoms to first contact with medical personnel and hospital arrival. Other questions covered help from bystanders and whether patients called for ambulances when they noticed stroke symptoms.

Patients were about 61 years old, on average. Sixty-nine percent were men.

After noticing the start of symptoms, patients took anywhere from half an hour to nine hours to seek help and 1.3 hours to more than 14 hours to get to the hospital. The researchers considered hospital arrival to be late if it happened more than three hours after symptoms started.

Severe or Not?

Patients who thought their symptoms were severe were less than half as likely to delay seeking treatment, according to the study.

"Regarding the perception of severity of symptoms, we found that patients who perceived their symptoms to be severe were more likely to seek help quickly than those who perceived their symptoms as not severe," Mandelzweig tells WebMD in an email.

"I must point out, however, that the patient's perception of severity does not necessarily reflect the true clinical severity of the symptoms, but it is often what motivates him to [seek medical help]," she continues.

"It is also likely that a patient who perceives his symptoms as severe may be more inclined to contact an ambulance, which is clearly the preferred contact for quick transport of stroke patients to the hospital," Mandelzweig says.

Help From Bystanders

Patients were more than 80% less likely to delay seeking medical help if someone else noticed their symptoms and urged them to get help.

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