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J Stroke Cerebrovasc Dis. 2014 Sep;23(8):2091-2098. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.017. Epub 2014 Aug 10.

Poor awareness of stroke--a hospital-based study from South India: an urgent need for awareness programs.

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Department of Neurology, Narayana Medical College and Superspeciality Hospital, Nellore, Andhra Pradesh, India. Electronic address:
Narayana Medical College, Nellore, Andhra Pradesh, India.
Department of Community Medicine, Medical College and Superspeciality Hospital, Nellore, Andhra Pradesh, India.



Stroke treatment has reached a new benchmark with thrombolytic therapy. However, India has witnessed a tremendous increase in morbidity and mortality of stroke over the past few decades. The prime deciding factor is initiation of treatment within the time window, which requires early recognition of stroke symptoms. We wished to analyze the lacunae in the stroke knowledge in our population. This hospital-based study assessed awareness of the public regarding stroke.


Two trained medical students interviewed accompanying relatives using a structured questionnaire. Data were analyzed using Statistical Package for the Social Sciences, version 20. Univariate and multivariate analyses were done. Descriptive results are presented as mean ± SD. P less than .05 was considered as statistically significant.


In total, 350 individuals formed the study group; mean age was 40.23 ± 13.4 years constituting 145 males (47.5%) and 205 females (58.5%). Only 50 (14%) respondents could identify that the patient had developed stroke; however, 35% respondents identified brain as the organ involved for the presenting complaints and 34% could identify the warning symptoms of stroke, limb weakness being the most common (30%). Sources of information were friends and media (8%). Median time of reaching the hospital was 10 hours with patients transported by ambulance reaching early (P < .03); 80% of patients were fed in drowsy state during transport. More than 50% of the respondents were not able to identify the risk factors nor were aware that stroke is a preventable or a life-threatening disease. Multivariate logistic regression analysis confirmed that higher level of education was the only variable, which correlated with the organ identification (P < .001), stroke recognition (P < .002), and identification of the warning symptoms (P < .001).


This hospital-based study reveals that there is a poor knowledge of recognition of stroke, its warning signs, risk factors, and prehospital care. There is an urgent need to design stroke awareness programs in the country with emphasis on ambulance service to minimize the time to thrombolysis.


Awareness; Risk factors; Stroke; Warning signs

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