Stroke awareness decreases prehospital delay after acute ischemic stroke in korea

Young S. Kim, Sang Soon Park, Hee Joon Bae, A. Hyun Cho, Yong Jin Cho, Moon Ku Han, Ji H. Heo, Kyusik Kang, Dong Eog Kim, Hahn Y. Kim, Gyeong Moon Kim, Sun U. Kwon, Hyung Min Kwon, Byung Chul Lee, Kyung B. Lee, Seung Hoon Lee, Su Ho Lee, Yong Seok Lee, Hyo S. Nam, Mi Sun OhJong Moo Park, Joung Ho Rha, Kyung Ho Yu, Byung Woo Yoon

Research output: Contribution to journalArticle

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Abstract

Background: Delayed arrival at hospital is one of the major obstacles in enhancing the rate of thrombolysis therapy in patients with acute ischemic stroke. Our study aimed to investigate factors associated with prehospital delay after acute ischemic stroke in Korea.Methods: A prospective, multicenter study was conducted at 14 tertiary hospitals in Korea from March 2009 to July 2009. We interviewed 500 consecutive patients with acute ischemic stroke who arrived within 48 hours. Univariate and multivariate analyses were performed to evaluate factors influencing prehospital delay.Results: Among the 500 patients (median 67 years, 62% men), the median time interval from symptom onset to arrival was 474 minutes (interquartile range, 170-1313). Early arrival within 3 hours of symptom onset was significantly associated with the following factors: high National Institutes of Health Stroke Scale (NIHSS) score, previous stroke, atrial fibrillation, use of ambulance, knowledge about thrombolysis and awareness of the patient/bystander that the initial symptom was a stroke. Multivariable logistic regression analysis indicated that awareness of the patient/bystander that the initial symptom was a stroke (OR 4.438, 95% CI 2.669-7.381), knowledge about thrombolysis (OR 2.002, 95% CI 1.104-3.633) and use of ambulance (OR 1.961, 95% CI 1.176-3.270) were significantly associated with early arrival.Conclusions: In Korea, stroke awareness not only on the part of patients, but also of bystanders, had a great impact on early arrival at hospital. To increase the rate of thrombolysis therapy and the incidence of favorable outcomes, extensive general public education including how to recognize stroke symptoms would be important.

Original languageEnglish
Article number2
JournalBMC neurology
Volume11
DOIs
Publication statusPublished - 2011 Jan 6

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Korea
Stroke
Ambulances
National Institutes of Health (U.S.)
Tertiary Care Centers
Atrial Fibrillation
Multicenter Studies
Multivariate Analysis
Logistic Models
Regression Analysis
Prospective Studies
Education
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Kim, Y. S., Park, S. S., Bae, H. J., Cho, A. H., Cho, Y. J., Han, M. K., ... Yoon, B. W. (2011). Stroke awareness decreases prehospital delay after acute ischemic stroke in korea. BMC neurology, 11, [2]. https://doi.org/10.1186/1471-2377-11-2
Kim, Young S. ; Park, Sang Soon ; Bae, Hee Joon ; Cho, A. Hyun ; Cho, Yong Jin ; Han, Moon Ku ; Heo, Ji H. ; Kang, Kyusik ; Kim, Dong Eog ; Kim, Hahn Y. ; Kim, Gyeong Moon ; Kwon, Sun U. ; Kwon, Hyung Min ; Lee, Byung Chul ; Lee, Kyung B. ; Lee, Seung Hoon ; Lee, Su Ho ; Lee, Yong Seok ; Nam, Hyo S. ; Oh, Mi Sun ; Park, Jong Moo ; Rha, Joung Ho ; Yu, Kyung Ho ; Yoon, Byung Woo. / Stroke awareness decreases prehospital delay after acute ischemic stroke in korea. In: BMC neurology. 2011 ; Vol. 11.
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title = "Stroke awareness decreases prehospital delay after acute ischemic stroke in korea",
abstract = "Background: Delayed arrival at hospital is one of the major obstacles in enhancing the rate of thrombolysis therapy in patients with acute ischemic stroke. Our study aimed to investigate factors associated with prehospital delay after acute ischemic stroke in Korea.Methods: A prospective, multicenter study was conducted at 14 tertiary hospitals in Korea from March 2009 to July 2009. We interviewed 500 consecutive patients with acute ischemic stroke who arrived within 48 hours. Univariate and multivariate analyses were performed to evaluate factors influencing prehospital delay.Results: Among the 500 patients (median 67 years, 62{\%} men), the median time interval from symptom onset to arrival was 474 minutes (interquartile range, 170-1313). Early arrival within 3 hours of symptom onset was significantly associated with the following factors: high National Institutes of Health Stroke Scale (NIHSS) score, previous stroke, atrial fibrillation, use of ambulance, knowledge about thrombolysis and awareness of the patient/bystander that the initial symptom was a stroke. Multivariable logistic regression analysis indicated that awareness of the patient/bystander that the initial symptom was a stroke (OR 4.438, 95{\%} CI 2.669-7.381), knowledge about thrombolysis (OR 2.002, 95{\%} CI 1.104-3.633) and use of ambulance (OR 1.961, 95{\%} CI 1.176-3.270) were significantly associated with early arrival.Conclusions: In Korea, stroke awareness not only on the part of patients, but also of bystanders, had a great impact on early arrival at hospital. To increase the rate of thrombolysis therapy and the incidence of favorable outcomes, extensive general public education including how to recognize stroke symptoms would be important.",
author = "Kim, {Young S.} and Park, {Sang Soon} and Bae, {Hee Joon} and Cho, {A. Hyun} and Cho, {Yong Jin} and Han, {Moon Ku} and Heo, {Ji H.} and Kyusik Kang and Kim, {Dong Eog} and Kim, {Hahn Y.} and Kim, {Gyeong Moon} and Kwon, {Sun U.} and Kwon, {Hyung Min} and Lee, {Byung Chul} and Lee, {Kyung B.} and Lee, {Seung Hoon} and Lee, {Su Ho} and Lee, {Yong Seok} and Nam, {Hyo S.} and Oh, {Mi Sun} and Park, {Jong Moo} and Rha, {Joung Ho} and Yu, {Kyung Ho} and Yoon, {Byung Woo}",
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language = "English",
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Kim, YS, Park, SS, Bae, HJ, Cho, AH, Cho, YJ, Han, MK, Heo, JH, Kang, K, Kim, DE, Kim, HY, Kim, GM, Kwon, SU, Kwon, HM, Lee, BC, Lee, KB, Lee, SH, Lee, SH, Lee, YS, Nam, HS, Oh, MS, Park, JM, Rha, JH, Yu, KH & Yoon, BW 2011, 'Stroke awareness decreases prehospital delay after acute ischemic stroke in korea', BMC neurology, vol. 11, 2. https://doi.org/10.1186/1471-2377-11-2

Stroke awareness decreases prehospital delay after acute ischemic stroke in korea. / Kim, Young S.; Park, Sang Soon; Bae, Hee Joon; Cho, A. Hyun; Cho, Yong Jin; Han, Moon Ku; Heo, Ji H.; Kang, Kyusik; Kim, Dong Eog; Kim, Hahn Y.; Kim, Gyeong Moon; Kwon, Sun U.; Kwon, Hyung Min; Lee, Byung Chul; Lee, Kyung B.; Lee, Seung Hoon; Lee, Su Ho; Lee, Yong Seok; Nam, Hyo S.; Oh, Mi Sun; Park, Jong Moo; Rha, Joung Ho; Yu, Kyung Ho; Yoon, Byung Woo.

In: BMC neurology, Vol. 11, 2, 06.01.2011.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Stroke awareness decreases prehospital delay after acute ischemic stroke in korea

AU - Kim, Young S.

AU - Park, Sang Soon

AU - Bae, Hee Joon

AU - Cho, A. Hyun

AU - Cho, Yong Jin

AU - Han, Moon Ku

AU - Heo, Ji H.

AU - Kang, Kyusik

AU - Kim, Dong Eog

AU - Kim, Hahn Y.

AU - Kim, Gyeong Moon

AU - Kwon, Sun U.

AU - Kwon, Hyung Min

AU - Lee, Byung Chul

AU - Lee, Kyung B.

AU - Lee, Seung Hoon

AU - Lee, Su Ho

AU - Lee, Yong Seok

AU - Nam, Hyo S.

AU - Oh, Mi Sun

AU - Park, Jong Moo

AU - Rha, Joung Ho

AU - Yu, Kyung Ho

AU - Yoon, Byung Woo

PY - 2011/1/6

Y1 - 2011/1/6

N2 - Background: Delayed arrival at hospital is one of the major obstacles in enhancing the rate of thrombolysis therapy in patients with acute ischemic stroke. Our study aimed to investigate factors associated with prehospital delay after acute ischemic stroke in Korea.Methods: A prospective, multicenter study was conducted at 14 tertiary hospitals in Korea from March 2009 to July 2009. We interviewed 500 consecutive patients with acute ischemic stroke who arrived within 48 hours. Univariate and multivariate analyses were performed to evaluate factors influencing prehospital delay.Results: Among the 500 patients (median 67 years, 62% men), the median time interval from symptom onset to arrival was 474 minutes (interquartile range, 170-1313). Early arrival within 3 hours of symptom onset was significantly associated with the following factors: high National Institutes of Health Stroke Scale (NIHSS) score, previous stroke, atrial fibrillation, use of ambulance, knowledge about thrombolysis and awareness of the patient/bystander that the initial symptom was a stroke. Multivariable logistic regression analysis indicated that awareness of the patient/bystander that the initial symptom was a stroke (OR 4.438, 95% CI 2.669-7.381), knowledge about thrombolysis (OR 2.002, 95% CI 1.104-3.633) and use of ambulance (OR 1.961, 95% CI 1.176-3.270) were significantly associated with early arrival.Conclusions: In Korea, stroke awareness not only on the part of patients, but also of bystanders, had a great impact on early arrival at hospital. To increase the rate of thrombolysis therapy and the incidence of favorable outcomes, extensive general public education including how to recognize stroke symptoms would be important.

AB - Background: Delayed arrival at hospital is one of the major obstacles in enhancing the rate of thrombolysis therapy in patients with acute ischemic stroke. Our study aimed to investigate factors associated with prehospital delay after acute ischemic stroke in Korea.Methods: A prospective, multicenter study was conducted at 14 tertiary hospitals in Korea from March 2009 to July 2009. We interviewed 500 consecutive patients with acute ischemic stroke who arrived within 48 hours. Univariate and multivariate analyses were performed to evaluate factors influencing prehospital delay.Results: Among the 500 patients (median 67 years, 62% men), the median time interval from symptom onset to arrival was 474 minutes (interquartile range, 170-1313). Early arrival within 3 hours of symptom onset was significantly associated with the following factors: high National Institutes of Health Stroke Scale (NIHSS) score, previous stroke, atrial fibrillation, use of ambulance, knowledge about thrombolysis and awareness of the patient/bystander that the initial symptom was a stroke. Multivariable logistic regression analysis indicated that awareness of the patient/bystander that the initial symptom was a stroke (OR 4.438, 95% CI 2.669-7.381), knowledge about thrombolysis (OR 2.002, 95% CI 1.104-3.633) and use of ambulance (OR 1.961, 95% CI 1.176-3.270) were significantly associated with early arrival.Conclusions: In Korea, stroke awareness not only on the part of patients, but also of bystanders, had a great impact on early arrival at hospital. To increase the rate of thrombolysis therapy and the incidence of favorable outcomes, extensive general public education including how to recognize stroke symptoms would be important.

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U2 - 10.1186/1471-2377-11-2

DO - 10.1186/1471-2377-11-2

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VL - 11

JO - BMC Neurology

JF - BMC Neurology

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