Introduction: Optimal time of referral after stroke and the use of new therapies, such as r-tPA and blood pressure control, could accelerate symptoms recovery after stroke. The aim of this study was to investigate factors contributing to the delay in referral to hospitals after the occurrence of acute stroke.

Methods: This analytic-descriptive study included 425 patients, who had referred to the Hamadan Farshchian hospital during years 2015 and 2016. Demographic data, time of referring to medical center, the time of occurrence of stroke, risk factors, clinical symptoms of stroke, way of referring, distance from medical center and type of stroke by using a questionnaire and checklist were recorded. The SPSS (version 16) software was used for all calculations.

Results: The mean age of patients in this study was 70.12 years old. Overall, 260 patients (61.2%) were male and 85.6% had ischemic stroke. Mean time of referral to first treatment center and Farshchian hospital was 2.06 and 4.77 hours, respectively. A total of 36.2% patients arrived to Farshchian hospital, within less than 2 hours. Factors that prolonged time to presentation were male gender, ischemic stroke, low education, being at a location far from the medical center, referral from other medical centers, being single, having no witness during stroke, and having a stroke at home, and during night. The most common symptoms in patients who were referred within less than two hours were confusion and loss of consciousness with frequency of 29.2%. The most common risk factor in 61.4% of patients, who were referred within less than 2 hours, was high blood pressure.

Conclusion: This study showed mean time of referral for treatment after stroke was high. Influential elements that could possibly delay hospital arrival include, being at a location far from the medical center, no adequate knowledge about stroke symptom, having stroke at night, not referring directly to the medical center, being single, and no witness during stroke.

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