Sociodemographic Profile and Prehospital Pathway of Patients Admitted for Acute Stroke in the Emergency Department of the Brazzaville University Hospital Center
Introduction: Stroke represents a major public health challenge because of its high morbidity and mortality. It requires urgent management, which remains limited in low-resource settings due to the absence of a structured stroke care pathway, thereby hindering optimal stroke management and prevention. Objective: To describe the sociodemographic profile and prehospital pathway of stroke patients admitted to the Emergency Department of Brazzaville University Hospital Center (CHUB). PatientsandMethods: A descriptive cross-sectional study with prospective data collection was conducted over a three-month period in the Emergency Department of CHUB. Included were patients aged 18 years and older, admitted for stroke confirmed by brain imaging within 72 hours after symptom onset. Study variables included sociodemographic characteristics and data related to the prehospital pathway. Results: Among the 2753 patients admitted during the study period, stroke was suspected in 200 patients and imaging-confirmed in 164 cases. The mean age was 61.31 ± 13.21 years, with a male predominance (60%). Most patients were single (54.88%), had primary-level education (58.54%), and belonged to a low socioeconomic group (57.93%). The prehospital pathway was mainly characterized by direct admission from home (62.19%), whereas 37.81% of patients were referred from another healthcare facility. Taxi was the predominant mode of transportation (78.04%). Regarding admission delays, 13.79% of ischemic stroke patients were managed within 4.5 hours of symptom onset, while 33.70% of hemorrhagic stroke patients were admitted within 24 hours. Conclusion: Stroke mainly affects socially disadvantaged patients and remains characterized by prolonged admission delays and reliance on non-medicalized transport. Improving the prehospital pathway is a major lever for achieving earlier and more effective stroke care.
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