Effect of Transport Time on the Use of Reperfusion Therapy for Patients with Acute Ischemic Stroke in Korea
We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke. We identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicente...
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| Published in | Journal of Korean medical science Vol. 36; no. 11; pp. e77 - 12 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
The Korean Academy of Medical Sciences
22.03.2021
대한의학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1011-8934 1598-6357 1598-6357 |
| DOI | 10.3346/jkms.2021.36.e77 |
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| Abstract | We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke.
We identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society.
Of 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time (
= 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes.
The use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time. |
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| AbstractList | We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke.BACKGROUNDWe investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke.We identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society.METHODSWe identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society.Of 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time (P = 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes.RESULTSOf 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time (P = 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes.The use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time.CONCLUSIONThe use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time. Background: We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke. Methods: We identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society. Results: Of 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time (P = 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes. Conclusion: The use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time. KCI Citation Count: 0 We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke. We identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society. Of 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time ( = 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes. The use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time. |
| Author | Lee, Jun Lee, Byung-Chul Bae, Hee-Joon Park, Jong-Moo Lee, Soo-Joo Choi, Jay Chol Kang, Jihoon Cho, Yong-Jin Kim, Anthony S. Kang, Chul-Hoo Kim, Dong-Eog Kim, Joong-Goo Kim, Joon-Tae Park, Tai Hwan Lee, Ji-Sung Cha, Jae-Kwan Lee, Kyung Bok |
| AuthorAffiliation | 10 Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea 11 Department of Neurology, Dong-A University College of Medicine, Busan, Korea 15 Department of Neurology, University of California San Francisco, San Francisco, CA, USA 12 Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea 7 Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Korea 1 Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea 2 Institute of Medical Science, Jeju National University, Jeju, Korea 13 Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea 3 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea 14 Clinical Research Center, Asan Medical Center, Seoul, Korea 4 Department of Neurology, Eulji University Hospital, Daejeon, Korea 5 Department of Neur |
| AuthorAffiliation_xml | – name: 5 Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Korea – name: 1 Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea – name: 7 Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Korea – name: 15 Department of Neurology, University of California San Francisco, San Francisco, CA, USA – name: 13 Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea – name: 8 Department of Neurology, Soonchunhyang University College of Medicine, Seoul, Korea – name: 12 Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea – name: 3 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea – name: 6 Department of Neurology, Seoul Medical Center, Seoul, Korea – name: 10 Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea – name: 11 Department of Neurology, Dong-A University College of Medicine, Busan, Korea – name: 9 Department of Neurology, Yeungnam University Hospital, Daegu, Korea – name: 14 Clinical Research Center, Asan Medical Center, Seoul, Korea – name: 2 Institute of Medical Science, Jeju National University, Jeju, Korea – name: 4 Department of Neurology, Eulji University Hospital, Daejeon, Korea |
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| CitedBy_id | crossref_primary_10_3346_jkms_2022_37_e305 crossref_primary_10_3390_ijerph19053050 crossref_primary_10_3389_fneur_2022_809343 crossref_primary_10_3346_jkms_2022_37_e270 crossref_primary_10_1038_s41598_022_08025_2 |
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| Keywords | Endovascular Treatment Reperfusion Utilization Thrombolysis Ischemic Stroke |
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We... We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic... Background: We investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic... |
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| Title | Effect of Transport Time on the Use of Reperfusion Therapy for Patients with Acute Ischemic Stroke in Korea |
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