뇌졸중홍보캠페인에 사용된 대표적인 다섯 가지 대표적 뇌졸중 증상의 타당도조사
Validation of Five Cardinal Symptoms Used for Stroke Awareness Campaign
0
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background: For the improvement in stroke care, we have campaigned for stroke warning signs and its symptoms. However, few reports on the validation of symptom selection in the campaign have been published till now. Methods: Based on the prospective stroke registry, patients were identified, who were hospitalized with stroke within 7days from the stroke onset and had relevant lesions on their brain images. One presenting symptom was selected in each patient through review of electronic medical records by an investigator, and those collected symptoms were classified into 5 symptom categories or the unclassified. Those 5 symptom categories were developed and are being used in the stroke awareness campaign in 2009 by the Korean Stroke Society (KSS). Results: A total of 3027 patients (age, 66.57±12.6 years; male, 58.2%) were enrolled in our study. The rate of frequency of each categorized symptom was 54.9% for unilateral numbness or weakness, 27.5% for confusion or speech disturbance,2.8% for visual disturbance, 10.5% for dizziness or gait disturbance, 2.3% for severe headache, and 2.0% for the unclassified. Ninety-eight percent of stroke patients were classified into one of the 5 symptom categories. Confusion or speech disturbance was associated with the shorter pre-hospital delay, whereas dizziness or gait disturbance with the longer delay. Dizziness was the most frequent symptom in TIA, and so was severe headache in hemorrhagic stroke. Conclusions: Our study shows that the 5 stroke warning symptoms of the KSS campaign represent well the presenting symptoms of Korean patients with acute stroke or TIA.
Abstract
Background: For the improvement in stroke care, we have campaigned for stroke warning signs and its symptoms. However, few reports on the validation of symptom selection in the campaign have been published till now. Methods: Based on the prospective stroke registry, patients were identified, who were hospitalized with stroke within 7days from the stroke onset and had relevant lesions on their brain images. One presenting symptom was selected in each patient through review of electronic medical records by an investigator, and those collected symptoms were classified into 5 symptom categories or the unclassified. Those 5 symptom categories were developed and are being used in the stroke awareness campaign in 2009 by the Korean Stroke Society (KSS). Results: A total of 3027 patients (age, 66.57±12.6 years; male, 58.2%) were enrolled in our study. The rate of frequency of each categorized symptom was 54.9% for unilateral numbness or weakness, 27.5% for confusion or speech disturbance,2.8% for visual disturbance, 10.5% for dizziness or gait disturbance, 2.3% for severe headache, and 2.0% for the unclassified. Ninety-eight percent of stroke patients were classified into one of the 5 symptom categories. Confusion or speech disturbance was associated with the shorter pre-hospital delay, whereas dizziness or gait disturbance with the longer delay. Dizziness was the most frequent symptom in TIA, and so was severe headache in hemorrhagic stroke. Conclusions: Our study shows that the 5 stroke warning symptoms of the KSS campaign represent well the presenting symptoms of Korean patients with acute stroke or TIA.
참고문헌 (33)
- Annual Report on the Cause of Death Statistics, "Office KNS", ~ (2008)
- Adams HP Jr, "Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association", American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists, 2007, pp.38, 1655~1711
- 이신호, "급성 뇌혈관 질환이 의심되는 환자에서 병원도착 지연요인", 대한응급의학회지, 17(5), pp.431~437 (2006), 대한응급의학회
- 뇌졸중 적정성 평가 보고서, "전혜영", 건강보험심사평가원, ~ (2007)
- Alberts MJ, "Effects of public and professional education on reducing the delay in presentation and referral of stroke patients", Stroke, 23, pp.352~356 (1992)
- 이재진, "뇌졸중에 대한 지식이 급성기 뇌졸중 환자들의 병원도착 전 시간 지연에 주는 영향", 대한신경과학회지, 27(2), pp.123~128 (2009), 대한신경과학회
- Hodgson C, "Can mass media influence emergency department visits for stroke?", Stroke, 38, pp.2115~2122 (2007)
- "Stroke Warning Signs"[URL]
- "Know the Signs"[URL]
- Wall HK, "Addressing stroke signs and symptoms through public education: the Stroke Heroes Act FAST campaign", Prev Chronic Dis, 5, pp.49~ (2008)
- "Give me 5 for stroke" (2008)[URL]
- "Korean Stroke Society"[URL]
- Heo JH, "Presentation time to hospital and recognition of stroke in patients with ischemic stroke", J Korean Neurol Assoc, 18, pp.125~131 (2000)
- Jung KY, "Variables associated with delayed hospital arrival of stroke patients living in taejon and its suburban areas", J Korean Neurol Assoc, 13, pp.207~213 (1995)
- Cho YJ, "Factors related to hospital arrival time of acute stroke patients who visit Seoul National University Hospital", J Korean Neurol Assoc, 14, pp.696~703 (1996)
- Recommendations on stroke prevention, diagnosis, and therapy, "Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders", Stroke, 20, pp.1407~1431 (1989)
- Sacco RL, "Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association", American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline, 2006, pp.113, 409~449
- Goldstein LB, "Interrater reliability of the NIH stroke scale", Arch Neurol, 46, pp.660~662 (1989)
- Adams HP Jr, "Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment", Stroke, 24, pp.35~41 (1993)
- Jung KY, "Variable associated with delayed hospital arrival of stroke patients living in taejon and its suburban area", J Korean Neurol Assoc, 13, pp.207~213 (1995)
- Gargano JW, "Do presenting symptoms explain sex differences in emergency department delays among patients with acute stroke?", Stroke, 40, pp.1114~1120 (2009)
- Jungehulsing GJ, "Prevalence of stroke and stroke symptoms: a population- based survey of 28,090 participants", Neuroepidemiology, 30, pp.51~57 (2008)
- Howard VJ, "High prevalence of stroke symptoms among persons without a diagnosis of stroke or transient ischemic attack in a general population : the REasons for Geographic And Racial Differences in Stroke(REGARDS)study", Arch Intern Med, 166, pp.1952~1958 (2006)
- Abe IM, "Stroke prevalence in a poor neighbourhood of Sao Paulo, Brazil: applying a stroke symptom questionnaire", Int J Stroke, 6, pp.33~39 (2011)
- Teuschl Y, "Stroke education : discrepancies among factors influencing prehospital delay and stroke knowledge", Int J Stroke, 5, pp.187~208 (2010)
- Reeves M, "Sex differences in the use of intravenous rt-PA thrombolysis treatment for acute ischemic stroke : a meta-analysis", Stroke, 40, pp.1743~1749 (2009)
- 이신득, "급성 허혈성 뇌졸중 증상의 남녀차이에 대한 예비연구", 대한응급의학회지, 18(1), pp.26~31 (2007), 대한응급의학회
- Cheung RT, "Hong Kong patients' knowledge of stroke does not influence time-to-hospital presentation", J Clin Neurosci, 8, pp.311~314 (2001)
- Foerch C, "Sex disparity in the access of elderly patients to acute stroke care", Stroke, 38, pp.2123~2126 (2007)
- Lisabeth LD, "Acute stroke symptoms : comparing women and men", Stroke, 40, pp.2031~2036 (2009)
- Labiche LA, "Sex and acute stroke presentation", Ann Emerg Med, 40, pp.453~460 (2002)
- Sridharan SE, "Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum Stroke Registry", Stroke, 40, pp.1212~1218 (2009)
- Engstrom G, "Geographic distribution of stroke incidence within an urban population : relations to socioeconomic circumstances and prevalence of cardiovascular risk factors", Stroke, 32, pp.1098~1103 (2001)