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증상발생 48시간 이내의 급성 뇌경색과 일과성허혈발작 환자에서 최근 4년간 내원 시간 단축과 관련된 요인

Factors Associated With Reduced Prehospital Delay Over 4 Years in Patients With Acute Ischemic Stroke or Transient Ischemic Attack Within 48 Hours of Symptom Onset

박종무|김병건|권오현|이정주|구자성|박지영|이지성|김석주
대한신경과학회 (Korean Neurological Association)|2011.05|대한신경과학회지 (Journal of the Korean Neurological Association)|제29권 제2호|pp. 81-88

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참고문헌

키워드

Ischemic strokeTransient ischemic attackPrehospital delay
주제분류신경과학

초록

Background: Prehospital delay is a major obstacle for successful treatment of acute stroke. We investigated the annual change of prehospital delay and related factors in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). Methods: From prospective patient registry, demographic and clinical characteristics of patients who presented within 48 hours of symptom onset after AIS or TIA from 2005 to 2008 were analyzed. We compared the annual change of prehospital delay (time from symptom onset to hospital arrival) and the proportion of early arrival (EA-3, prehospital delay<3 h; EA-6, prehospital delay<6 h). We also investigated factors associated with prehospital delay and early arrival. Results: Of 612 patients, 623 events of AIS or TIA were analyzed. The adjusted geometric mean (95% CI) of prehospital delay (hours) was 7.42 (6.07-9.06) in 2005, 8.18 (6.76-9.89) in 2006, 4.39 (3.50-5.51) in 2007, and 4.02 (3.10-5.22) in 2008(p<0.01). The proportion of early arrival (year) was 23.6% (2005), 31% (2006), 58% (2007), 54% (2008) for EA-3 (p<0.001)and 38.8% (2005), 32.5% (2006), 51.6% (2007), 75% (2008) for EA-6 (p<0.001). Compared with 2006, the adjusted odds (95%CI) for early arrival were 1.54 (0.87-2.71) in 2005, 1.91 (1.11-3.30) in 2007, 2.29 (1.31-4.01) in 2008 for EA-3 and 1.37(0.84-2.25) in 2005, 1.73 (1.06-2.81) in 2007, 2.03 (1.23-3.36) in 2008 for EA-6. Younger age, severe neurologic deficit,admission through emergency department, cardioembolic stroke, and TIA were also independently associated with early arrival. Conclusions: From 2005 to 2008, prehospital delay decreased and potential candidates for thrombolytic therapy increased significantly.

Abstract

Background: Prehospital delay is a major obstacle for successful treatment of acute stroke. We investigated the annual change of prehospital delay and related factors in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). Methods: From prospective patient registry, demographic and clinical characteristics of patients who presented within 48 hours of symptom onset after AIS or TIA from 2005 to 2008 were analyzed. We compared the annual change of prehospital delay (time from symptom onset to hospital arrival) and the proportion of early arrival (EA-3, prehospital delay<3 h; EA-6, prehospital delay<6 h). We also investigated factors associated with prehospital delay and early arrival. Results: Of 612 patients, 623 events of AIS or TIA were analyzed. The adjusted geometric mean (95% CI) of prehospital delay (hours) was 7.42 (6.07-9.06) in 2005, 8.18 (6.76-9.89) in 2006, 4.39 (3.50-5.51) in 2007, and 4.02 (3.10-5.22) in 2008(p<0.01). The proportion of early arrival (year) was 23.6% (2005), 31% (2006), 58% (2007), 54% (2008) for EA-3 (p<0.001)and 38.8% (2005), 32.5% (2006), 51.6% (2007), 75% (2008) for EA-6 (p<0.001). Compared with 2006, the adjusted odds (95%CI) for early arrival were 1.54 (0.87-2.71) in 2005, 1.91 (1.11-3.30) in 2007, 2.29 (1.31-4.01) in 2008 for EA-3 and 1.37(0.84-2.25) in 2005, 1.73 (1.06-2.81) in 2007, 2.03 (1.23-3.36) in 2008 for EA-6. Younger age, severe neurologic deficit,admission through emergency department, cardioembolic stroke, and TIA were also independently associated with early arrival. Conclusions: From 2005 to 2008, prehospital delay decreased and potential candidates for thrombolytic therapy increased significantly.

참고문헌 (30)

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