Factors Associated with Prehospital Delay in Patients with Acute Ischemic Stroke in Mueang District, Uthai Thani Province, Thailand

Abstract

Background: Acute ischemic stroke is a major public health concern in Thailand. Prehospital delay reduces opportunities for timely treatment, contributing to increased morbidity and mortality. However, evidence regarding factors associated with prehospital delay in Mueang Uthai Thani District remains scarce. Objectives: To evaluate the prevalence and factors associated with prehospital delay among patients with acute ischemic stroke in Mueang District, Uthai Thani Province, Thailand. Methods: This cross-sectional study included patients with acute ischemic stroke who received care at Uthai Thani Hospital between August 2024 and May 2025. Participants were interviewed using a questionnaire to collect demographic data (age, sex, marital status, education, occupation, income, underlying diseases) and details regarding the stroke and prehospital period, including time of symptom onset, recognition of symptoms as stroke, severity perception, emergency awareness, initial actions, transportation, and prehospital treatment. Factors associated with prehospital delay, defined as arrival more than 4.5 hours after symptom onset, were analyzed using descriptive statistics and Multivariable logistic regression. Results: Among 106 patients (mean age 65.5 years and 54.7% male). The prevalence of prehospital delay was 76.4%. Factors significantly associated with prehospital delay were gradual or fluctuating symptom onset (OR 21.96, 95%CI: 2.91, 166.07, p = .003) and initially choosing to observe symptoms or self-medicate (OR 20.82, 95%CI: 1.69, 255.32, p = .018). Conclusion: Awareness of stroke symptoms and patients’ initial response at symptom onset are significantly associated with prehospital delay.