Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study

Abstract Background Timely detection and early medical interventions are critical in reducing complications and mortality related to stroke. The duration from onset to hospital presentation is an essential factor in determining the outcome of stroke treatment. The sooner a stroke patient receives me...

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Main Authors: Biniyam Tedla Mamo, Dawit Bekele Tefera, Makida Girma Altaye, Ferehiwot Gebrehiwot Geram, Anteneh Mitiku Dano, Yeteshaw Bekele Sana, Feven Sahle Gebre, Zelalem Tazu Bonger
Format: Article
Language:English
Published: BMC 2025-04-01
Series:International Journal of Emergency Medicine
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Online Access:https://doi.org/10.1186/s12245-025-00839-x
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author Biniyam Tedla Mamo
Dawit Bekele Tefera
Makida Girma Altaye
Ferehiwot Gebrehiwot Geram
Anteneh Mitiku Dano
Yeteshaw Bekele Sana
Feven Sahle Gebre
Zelalem Tazu Bonger
author_facet Biniyam Tedla Mamo
Dawit Bekele Tefera
Makida Girma Altaye
Ferehiwot Gebrehiwot Geram
Anteneh Mitiku Dano
Yeteshaw Bekele Sana
Feven Sahle Gebre
Zelalem Tazu Bonger
author_sort Biniyam Tedla Mamo
collection DOAJ
description Abstract Background Timely detection and early medical interventions are critical in reducing complications and mortality related to stroke. The duration from onset to hospital presentation is an essential factor in determining the outcome of stroke treatment. The sooner a stroke patient receives medical attention, the better the chances of preventing long-term complications. Pre-hospitalization delays can significantly decrease the chances of successful therapy and recovery from stroke. Objective The study aims to assess predictors of delayed hospital presentation after a stroke attack. Method An unmatched case-control study was conducted from September 2021 to November 2023 at Yekatit 12 Hospital Medical College. Descriptive statistics were used to describe study variables. Bivariable and multivariable logistic regression were used to identify the predictors of delay hospital presentation after stroke attack. All statistical tests were run with a significance threshold of 5%. Result A total of 83 cases (presenting after four hours) and 166 controls (presenting within four or fewer hours) of an acute stroke patients were included in this study. The median duration of symptoms from the onset of stroke to hospital arrival were 24 h (IQR, 12 h) and 2 h(IQR,1 h) for cases and controls respectively. The study found that age 60 or less (AOR 1.75, 95% CI 1–3.09, p < 0.05), living outside of Addis Ababa (AOR 3.55, 95% CI 1.33–9.46, p < 0.011), onset of stroke happening at night (AOR 1.75, 95% CI 1.2–3.1, p < 0.05) and not having health insurance (AOR 0.43, 95% CI 0.23–0.8,p < 0.007) were identified as predicting factors of late presentation to hospital in stroke patients. Conclusion This study highlights key predictors of delayed hospital presentation in stroke patients. Specifically, age, place of residence, health insurance, and stroke onset time were significantly influence the timeliness of seeking medical care. Recognizing and addressing the predicting factors can improve the health care treatment outcome and help to design targeted health policies that reduce barriers to timely presentation of stroke patients.
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issn 1865-1380
language English
publishDate 2025-04-01
publisher BMC
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series International Journal of Emergency Medicine
spelling doaj-art-72abb1fecfcd4a6885e5272e581607732025-08-20T03:18:38ZengBMCInternational Journal of Emergency Medicine1865-13802025-04-011811710.1186/s12245-025-00839-xPredictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control studyBiniyam Tedla Mamo0Dawit Bekele Tefera1Makida Girma Altaye2Ferehiwot Gebrehiwot Geram3Anteneh Mitiku Dano4Yeteshaw Bekele Sana5Feven Sahle Gebre6Zelalem Tazu Bonger7Ohio State Global One Health Initiative, LLCOhio State Global One Health Initiative, LLCYehuleshet Neurology and Internal medicine specialty clinicWashington Medical CenterYekatit 12 Hospital Medical CollegeCollege of Health Sciences, Addis Ababa UniversityGaramuleta General HospitalOhio State Global One Health Initiative, LLCAbstract Background Timely detection and early medical interventions are critical in reducing complications and mortality related to stroke. The duration from onset to hospital presentation is an essential factor in determining the outcome of stroke treatment. The sooner a stroke patient receives medical attention, the better the chances of preventing long-term complications. Pre-hospitalization delays can significantly decrease the chances of successful therapy and recovery from stroke. Objective The study aims to assess predictors of delayed hospital presentation after a stroke attack. Method An unmatched case-control study was conducted from September 2021 to November 2023 at Yekatit 12 Hospital Medical College. Descriptive statistics were used to describe study variables. Bivariable and multivariable logistic regression were used to identify the predictors of delay hospital presentation after stroke attack. All statistical tests were run with a significance threshold of 5%. Result A total of 83 cases (presenting after four hours) and 166 controls (presenting within four or fewer hours) of an acute stroke patients were included in this study. The median duration of symptoms from the onset of stroke to hospital arrival were 24 h (IQR, 12 h) and 2 h(IQR,1 h) for cases and controls respectively. The study found that age 60 or less (AOR 1.75, 95% CI 1–3.09, p < 0.05), living outside of Addis Ababa (AOR 3.55, 95% CI 1.33–9.46, p < 0.011), onset of stroke happening at night (AOR 1.75, 95% CI 1.2–3.1, p < 0.05) and not having health insurance (AOR 0.43, 95% CI 0.23–0.8,p < 0.007) were identified as predicting factors of late presentation to hospital in stroke patients. Conclusion This study highlights key predictors of delayed hospital presentation in stroke patients. Specifically, age, place of residence, health insurance, and stroke onset time were significantly influence the timeliness of seeking medical care. Recognizing and addressing the predicting factors can improve the health care treatment outcome and help to design targeted health policies that reduce barriers to timely presentation of stroke patients.https://doi.org/10.1186/s12245-025-00839-xStrokeHospital delayAdult strokeCerebrovascular accidentLow resource setting
spellingShingle Biniyam Tedla Mamo
Dawit Bekele Tefera
Makida Girma Altaye
Ferehiwot Gebrehiwot Geram
Anteneh Mitiku Dano
Yeteshaw Bekele Sana
Feven Sahle Gebre
Zelalem Tazu Bonger
Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study
International Journal of Emergency Medicine
Stroke
Hospital delay
Adult stroke
Cerebrovascular accident
Low resource setting
title Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study
title_full Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study
title_fullStr Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study
title_full_unstemmed Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study
title_short Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study
title_sort predictors of pre hospital delay among stroke patients in yekatit 12 hospital addis ababa ethiopia unmatched case control study
topic Stroke
Hospital delay
Adult stroke
Cerebrovascular accident
Low resource setting
url https://doi.org/10.1186/s12245-025-00839-x
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