Factors associated with early hospital arrival in patients with acute ischemic stroke

Dongbeom Song, Eijirou Tanaka, Kijeong Lee, Shoichiro Sato, Masatoshi Koga, Young Dae Kim, Kazuyuki Nagatsuka, Kazunori Toyoda, Ji Hoe Heo

Research output: Contribution to journalArticle

11 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)159-167
Number of pages9
JournalJournal of Stroke
Volume17
Issue number2
DOIs
Publication statusPublished - 2015 May 1

Fingerprint

Stroke
Odds Ratio
Confidence Intervals
Korea
Japan
Multivariate Analysis
National Institutes of Health (U.S.)
Emergency Medical Services
Atrial Fibrillation
Registries
Health

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Song, Dongbeom ; Tanaka, Eijirou ; Lee, Kijeong ; Sato, Shoichiro ; Koga, Masatoshi ; Kim, Young Dae ; Nagatsuka, Kazuyuki ; Toyoda, Kazunori ; Heo, Ji Hoe. / Factors associated with early hospital arrival in patients with acute ischemic stroke. In: Journal of Stroke. 2015 ; Vol. 17, No. 2. pp. 159-167.
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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.",
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Song, D, Tanaka, E, Lee, K, Sato, S, Koga, M, Kim, YD, Nagatsuka, K, Toyoda, K & Heo, JH 2015, 'Factors associated with early hospital arrival in patients with acute ischemic stroke', Journal of Stroke, vol. 17, no. 2, pp. 159-167. https://doi.org/10.5853/jos.2015.17.2.159

Factors associated with early hospital arrival in patients with acute ischemic stroke. / Song, Dongbeom; Tanaka, Eijirou; Lee, Kijeong; Sato, Shoichiro; Koga, Masatoshi; Kim, Young Dae; Nagatsuka, Kazuyuki; Toyoda, Kazunori; Heo, Ji Hoe.

In: Journal of Stroke, Vol. 17, No. 2, 01.05.2015, p. 159-167.

Research output: Contribution to journalArticle

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AU - Song, Dongbeom

AU - Tanaka, Eijirou

AU - Lee, Kijeong

AU - Sato, Shoichiro

AU - Koga, Masatoshi

AU - Kim, Young Dae

AU - Nagatsuka, Kazuyuki

AU - Toyoda, Kazunori

AU - Heo, Ji Hoe

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N2 - 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.

AB - 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.

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