London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 657 590 Acute stroke: emergency management, stroke units and complications Stroke Patients’ Knowledge about Stroke in Brazil M.I.P. Panicio1, L.M. Mateus2, I.F. Ricarte3, M.M. Figueiredo4, T.F. Fukuda5, J.S Seixas6, M.M. Alves7, GSS Silva8 Universidade Federal de São Paulo, São Paulo, BRAZIL1, Universidade Federal de São Paulo, São Paulo, BRAZIL2, Universidade Federal de São Paulo, São Paulo, BRAZIL3, Universidade Fed-eral de São Paulo, São Paulo, BRAZIL4, Universidade Federal de São Paulo, São Paulo, BRAZIL5, Universidade Federal de São Paulo, São Paulo, BRAZIL6, Universidade Federal de São Paulo, São Paulo, BRAZIL7, Universidade Federal de São Paulo, São Paulo, BRAZIL8 Background: Little is known about stroke patients’ awareness about stroke warning signs and its therapeutic time window in Brazil. Understanding this knowledge gap is vital to planning effective education campaigns. Methods: We interviewed consecutive patients with acute stroke admitted to a tertiary public Hospital in Brazil. Data collected included demographics, mode of arrival, NIHSS scores and knowledge of stroke warning signs and therapeutic time window using a standardized questionnaire. Early arrival was defined as that within 4.5 hours of symptoms onset. Results: A total of 104 patients were interviewed; 86.3% had an ischemic stroke, and 13.7%, an intracerebral hem-orrhage. Although 66.2% of patients knew the warning signs of stroke, only 7.8% reported to know that stroke had a limited therapeutic time window. Patients who were aware of stroke signs and those who were not were similar in age, educational level, and household income. Patients aware of the stroke therapeutic time window had a trend towards a higher household income (median 1103 799, 3255) dollars/month versus (median 639 393, 983) dollars/month, p=0.06. Only 10.3% of the patients aware of stroke signs reported receiving information from a health care provider. Early arrivals, corresponding to 24% of patients, were more likely to arrive by ambulance (34.5% versus 11.6%, p=0.01) and had more severe strokes (NIHSS 14.4+/- 6.8 versus 7.7 +/- 6.5, p<0.01) than late arrivals. Stroke severity measured by the NIHSS was independently associated with early ar-rival (OR 1.26; 95% CI 1.05 to 1.52 for each point of the scale), but not knowledge of stroke symp-toms. Conclusions: Although more than two thirds of stroke patients reported knowledge of stroke warning signs, only few patients knew the importance of early arrival. Widespread public education about stroke in Brazil should focus on the importance of early arrival and can potentially increase the proportion of patients eligible for acute stroke treatments. 591 Acute stroke: emergency management, stroke units and complications Risk factors for chest infection after acute stroke P. Aruldoss1, K. Loganathan2, S. Subramonian3, P. Owusu-Agyei4 Peterborough City Hospital, Peterborough, UNITED KINGDOM1, Peterborough City Hospital, Peterborough, UNITED KINGDOM2, Peterborough City Hospital, Peterborough, UNITED KING-DOM3, Peterborough City Hospital, Peterborough, UNITED KINGDOM4 Background: Chest infection is a major cause of morbidity and mortality after acute stroke. Sellars et al identified certain risk factors which could be used to identify patients at high risk of developing pneumonia after acute stroke. These are age more than 65 years, speech disturbance, severity of post stroke dis-ability, cognitive impairment and a failed swallow on the initial water swallow test. The presence 2 or more of these risk factors carried 90.9 % sensitivity and 75.6 % specificity for the development of chest infection after acute stroke. Methods: To compared the presence of risk factors in Peterborough Hospital with that of the Sellars study. Case notes of patients with a diagnosis of chest infection following acute stroke were analysed from January 2010 to June 2010. Results: In this retrospective analysis when compared with the Sellars study for which the figures are given in brackets 89 %( 83 %) of patients were more than 65 years of age, 100 % (82%) had either dysar-thria or dysphasia, 97 %( 87%) had a modified Rankin score of equal or greater than 4, 24 %( 85%) had an abbreviated mental test score of less than 8 and 81 %( 71%) had a failed swallow.Cognitive impairment could not be assessed in more than half of the patients due to decreased level of con-sciousness. The mortality was particularly high, nearly 50 % of patients died. Conclusion: Age more than 65 years, speech disturbance, severe functional disability and failed swallow were strongly associated with the development of chest infection after stroke. All patients had more than 3 risk factors. These risk factors can be the basis for a simple screening tool on ad-mission to identify the patients at a greater risk of developing a chest infection following acute stroke. References: 1.Sellars et al :Risk factors for chest infection in acute stroke Stroke.2007; 38:2284-2291 2.NICE guidelines Stroke CG 68 July 2008
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