Barriers to On Time Delivery of Thrombolytic Therapy

Background and The new thrombolytic agents have opened a new horizon in the treatment of patients with stroke. However، the contraindication and delay in beginning of the drug have caused serious obstacles to apply this therapy. In this study we verified these obstacles in early beginning of thrombolytic treatment. In this cross sectional study، we investigated the patients with stroke attending Tehran Imam Hossain hospital from June 2010 to September 2011. The data including demographic features، financial status، previous medical history، and time interval were obtained using a questionnaire. The data was then analyzed in SPSS ver. 18 applying Student’s t-tests and Chi-square. Of 171 subjects، 151 were investigated. The mean age of the patients was 59. 7 years and they were 97 (64. 2%) male. The main barriers to delivery of thrombolytic therapy were losing the golden time (70. 3%)، drug contraindication (20. 9%)، absence of intensive care bed (5. 4%)، and financial problems (3. 4%). The average time from patient arrival time in emergency department to the time of physician’s visit، performing brain CT scan، neurology consultation and making the final decision were 11، 112، 211 and 320 minutes، respectively. The main obstacle to timely initiation of thrombolytic therapy is delay in referral to the emergency department. Therefore، public education to promote public awareness could be of great benefit in reducing the referral delay time.