ột số yếu tố ảnh hưởng đến thời gian nhập viện ở bệnh nhân nhồi máu não cấp

Acute cerebral infarction (nhồi máu não cấp) stands as a critical and prevalent form of cerebrovascular accident, characterized by cerebral ischemia leading to rapid neuronal damage. The principle of "time is brain" underscores the profound urgency for prompt intervention, as early revascularization is paramount to salvage the ischemic penumbra and mitigate irreversible brain injury. Despite significant advancements in acute stroke management, challenges persist, particularly concerning suboptimal rates of early patient hospitalization and the underutilization of thrombolytic therapies. This study addresses these critical gaps by investigating the key factors that influence the time from symptom onset to hospital admission in patients diagnosed with acute cerebral infarction.

Bác sĩ thần kinh, bác sĩ cấp cứu, nhà nghiên cứu y học, cán bộ y tế công cộng và các nhà hoạch định chính sách y tế liên quan đến quản lý đột quỵ.

This cross-sectional, retrospective descriptive study investigated factors influencing hospitalization time for 150 patients with acute cerebral infarction at Bach Mai Hospital between January and December 2023. The research aimed to identify variables correlating with both early and delayed patient arrival, crucial for improving clinical outcomes in **acute ischemic stroke**. Findings revealed an average hospitalization time of 661.5 minutes (11 hours), with a concerningly low 17.3% of patients arriving within the critical 4.5-hour therapeutic window. Key factors significantly associated with early hospitalization included higher educational levels, **stroke onset time** during the day, the presence of witnesses at symptom onset, utilization of ambulance transportation, a history of prior stroke or TIA, effective recognition of **stroke symptoms**, and knowledge about **thrombolytic drugs**. Conversely, factors contributing to delayed hospitalization were identified as a hospital distance greater than 15km and initial admission to a primary healthcare facility rather than a specialized stroke center. These findings underscore the urgent need for targeted public health interventions to enhance awareness of stroke signs and the importance of immediate medical attention. Strategies should focus on community education, improving pre-hospital care, and optimizing patient pathways to specialized stroke units. By addressing these modifiable factors, healthcare systems can strive to reduce treatment delays, maximize the therapeutic window for reperfusion therapies, and ultimately improve prognosis for patients experiencing acute cerebral infarction.