Clinical and Therapeutic Characteristics of Stroke and Their Implications on Outcomes: A Multi-center Study in Panama.

Introduction There are no previous studies that assess the time between stroke symptom onset and hospital arrival in Panama. With this study, we aim to describe the epidemiological, clinical, and therapeutic characteristics of the patients to determine whether our data on stroke care and outcomes align with those from other Latin American countries and nations with more advanced healthcare systems. Methods This prospective study included 214 stroke patients admitted to three healthcare centers in Panama between January and December 2023. Demographic, clinical, and therapeutic data were collected using a standardized instrument. Univariate analysis was then conducted in order to describe patient characteristics and their distribution across outcomes, which included discharge, critical care unit transfer, or death. Results Out of the 214 patients included in the study, 124 (57%) were men, and 88 (42%) were women. The main risk factors were arterial hypertension, type 2 diabetes, and previous history of stroke. The overall median time from symptom onset to arrival was 10 hours, and the median National Institutes of Health Stroke Scale (NIHSS) score on arrival was 5. The mean hospital stay was 10.4 days, and overall mortality was 38 (17.7%). Only five (2%) patients were able to receive intravenous thrombolysis. Discussion This study is the first to report the time from stroke symptom onset to hospital arrival in Panama, with a median recorded time of 10 hours. Despite national improvements in the length of stay and overall mortality, the negative results displayed by our study may be explained by the significant strain public hospitals face due to the high demand for their services. Conclusion The measured time in hours from symptom onset to arrival at a healthcare center across three centers in Panama was 10 hours, and thrombolysis was only recorded in five (2%) cases. Results reveal notable regional disparities and prompt further research on effective improvement strategies.