Factors Associated with Early Hospital Arrival in Patients with Acute Ischemic Stroke
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background and Purpose Factors associated with early arrival may vary according to the characteristics of the hospital. We investigated the factors associated with early hospital arrival in two different stroke centers located in Korea and Japan. Methods Consecutive patients with ischemic stroke arrived hospital within 48 hours of onset between January 2011 and December 2012 were identified and the clinical and time variables were retrieved from the prospective stroke registries of Severance Hospital of Yonsei University Health System (YUHS; Seoul, Korea) and National Cerebral and Cardiovascular Center (NCVC; Osaka, Japan). Subjects were dichotomized into early (time from onset to arrival ≤4.5 hours) and late (>4.5 hours) arrival groups. Univariate and multivariate analyses were performed to evaluate factors associated with early hospital arrival. Results A total of 1,966 subjects (992 from YUHS; 974 from NCVC) were included in this study. The median time from onset to arrival was 6.1 hours [interquartile range, 1.7-17.8 hours]. In multivariate analysis, the factors associated with early arrival were atrial fibrillation (Odds ratio [OR], 1.505; 95% confidence interval [CI], [1.168-1.939]), higher initial National Institute of Health Stroke Scale scores (OR, 1.037; 95% CI [1.023-1.051]), onset during daytime (OR, 2.799; 95% CI [2.173-3.605]), and transport by an emergency medical service (OR, 2.127; 95% CI [1.700-2.661]). These factors were consistently associated with early arrival in both hospitals. Conclusions Despite differences between the hospitals, there were common factors related to early arrival. Efforts to identify and modify these factors may promote early hospital arrival and improve stroke outcome.
Abstract
Background and Purpose Factors associated with early arrival may vary according to the characteristics of the hospital. We investigated the factors associated with early hospital arrival in two different stroke centers located in Korea and Japan. Methods Consecutive patients with ischemic stroke arrived hospital within 48 hours of onset between January 2011 and December 2012 were identified and the clinical and time variables were retrieved from the prospective stroke registries of Severance Hospital of Yonsei University Health System (YUHS; Seoul, Korea) and National Cerebral and Cardiovascular Center (NCVC; Osaka, Japan). Subjects were dichotomized into early (time from onset to arrival ≤4.5 hours) and late (>4.5 hours) arrival groups. Univariate and multivariate analyses were performed to evaluate factors associated with early hospital arrival. Results A total of 1,966 subjects (992 from YUHS; 974 from NCVC) were included in this study. The median time from onset to arrival was 6.1 hours [interquartile range, 1.7-17.8 hours]. In multivariate analysis, the factors associated with early arrival were atrial fibrillation (Odds ratio [OR], 1.505; 95% confidence interval [CI], [1.168-1.939]), higher initial National Institute of Health Stroke Scale scores (OR, 1.037; 95% CI [1.023-1.051]), onset during daytime (OR, 2.799; 95% CI [2.173-3.605]), and transport by an emergency medical service (OR, 2.127; 95% CI [1.700-2.661]). These factors were consistently associated with early arrival in both hospitals. Conclusions Despite differences between the hospitals, there were common factors related to early arrival. Efforts to identify and modify these factors may promote early hospital arrival and improve stroke outcome.
참고문헌 (22)
- Jauch EC, "Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2013, pp.44, 870~947
- Berkhemer OA, "A randomized trial of intraarterial treatment for acute ischemic stroke", N Engl J Med, 372, pp.11~20 (2015)
- de Los Ríos la Rosa F, "Eligibility for intravenous recombinant tissue-type plasminogen activator within a population: the effect of the European Cooperative Acute Stroke Study (ECASS) III trial", Stroke, 43, pp.1591~1595 (2012)
- Jin H, "Factors associated with prehospital delays in the presentation of acute stroke in urban China", Stroke, 43, pp.362~370 (2012)
- Khatri P, "Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke: an analysis of data from the Interventional Management of Stroke (IMS III) phase 3 trial", Lancet Neurol, 13, pp.567~574 (2014)
- Emberson J, "Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials", Lancet, 384, pp.1929~1935 (2014)
- Morris DL, "Prehospital and emergency department delays after acute stroke: the Genentech Stroke Presentation Survey", Stroke, 31, pp.2585~2590 (2000)
- Derex L, "Factors influencing early admission in a French stroke unit", Stroke, 33, pp.153~159 (2002)
- Faiz KW, "Prehospital delay in acute stroke and TIA", Emerg Med J, 30, pp.669~674 (2013)
- Fassbender K, "Streamlining of prehospital stroke management: the golden hour", Lancet Neurol, 12, pp.585~596 (2013)
- Gorelick PB, "Primary and comprehensive stroke centers: history, value and certification criteria", J Stroke, 15, pp.78~89 (2013)
- Lim S, "Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007", Diabetes Care, 34, pp.1323~1328 (2011)
- Minematsu K, "Guidelines for the intravenous application of recombinant tissue-type plasminogen activator (alteplase), the second edition, October 2012: a guideline from the Japan Stroke Society", J Stroke Cerebrovasc Dis, 22, pp.571~600 (2013)
- Inatomi Y, "Pre-hospital delay in the use of intravenous rt-PA for acute ischemic stroke in Japan", J Neurol Sci, 270, pp.127~132 (2008)
- Yanagida T, "Causes of prehospital delay in stroke patients in an urban aging society", J Clin Gerontol Geriatr, 5, pp.77~81 (2014)
- 홍근식, "Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke", 대한뇌졸중학회지, 15(2), pp.67~77 (2013), 대한뇌졸중학회[DOI]
- Kim YS, "Stroke awareness decreases prehospital delay after acute ischemic stroke in Korea", BMC Neurol, 11, pp.2~ (2011)
- Miyamatsu N, "Public awareness of early symptoms of stroke and information sources about stroke among the general Japanese population: the Acquisition of Stroke Knowledge Study", Cerebrovasc Dis, 35, pp.241~249 (2013)
- Miyashita F, "The effectiveness of a stroke educational activity performed by a schoolteacher for junior high school students", J Stroke Cerebrovasc Dis, 23, pp.1385~1390 (2014)
- Sakamoto Y, "Effects of stroke education using an animated cartoon and a manga on elementary school children", J Stroke Cerebrovasc Dis, 23, pp.1877~1881 (2014)
- Kim YS, "Public awareness of stroke in Korea: a population-based national survey.", Stroke, 43, pp.1146~1149 (2012)
- Ferro JM, "Cardioembolic stroke : an update", Lancet Neurol, 2, pp.177~188 (2003)