Hospital presentation after stroke in a community sample: the Mobile Stroke Project.

BACKGROUND: Existing data regarding time between stroke and presentation for treatment are largely derived from hospital-based or multicenter databases and may not accurately reflect presentation patterns for most hospitalized stroke patients.

METHODS: We evaluated a consecutive series of all hospitalized patients in Mobile County, Alabama.

RESULTS: We identified 1,010 hospitalized stroke patients. Of all patients with out-of-hospital stroke, 42% came to a hospital within 3 hours of symptom onset. There were no statistically significant interhospital differences. Being asleep at the time of stroke or being transported by family or friends significantly increased the likelihood of late arrival.

CONCLUSIONS: A minority of stroke patients arrive at a hospital early enough to qualify for acute intervention. Until development of acute therapies with longer therapeutic windows or more robust therapeutic benefit than tissue plasminogen activator (t-PA), effective stroke prevention strategies will exert a greater influence on stroke incidence and morbidity.