Acute Stroke Care in Korea in 2013–2014: National Averages and Disparities
| Autor: | Kwang-Yeol Park, Ji Sung Lee, Soo Joo Lee, Keon-Joo Lee, Hee-Joon Bae, Kyung Bok Lee, Juneyoung Lee, Ki Hwa Yang, Jong-Moo Park, Seong-Eun Kim, Jun Yup Kim, Hong Kyun Park, Beom Joon Kim, Jihoon Kang, Hyunji Oh, Tackeun Kim, Yong-Jin Cho, Ah Rum Choi, Mi Yeon Kang |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Subarachnoid hemorrhage Epidemiology medicine.medical_treatment Psychological intervention 03 medical and health sciences 0302 clinical medicine Republic of Korea medicine Emergency medical services Humans cardiovascular diseases 030212 general & internal medicine Stroke Cerebral Hemorrhage Aged Intracerebral hemorrhage business.industry Cerebral infarction Cerebral Infarction General Medicine Thrombolysis Subarachnoid Hemorrhage Middle Aged medicine.disease Hospitalization Treatment Outcome Emergency medicine Original Article Female Emergency Service Hospital business Neuroscience |
| Zdroj: | Journal of Korean Medical Science |
| ISSN: | 1598-6357 1011-8934 |
| Popis: | Background This study aimed to describe the current status of acute stroke care in Korea and explore disparities among hospitals and regions. Methods The 2013 and 2014 national stroke audit data and the national health insurance claims data were linked and used for this study. Stroke patients hospitalized via emergency rooms within 7 days of stroke onset were selected. Results A total of 19,608 patients treated in 216 hospitals were analyzed. Among them 76% had ischemic stroke; 15%, intracerebral hemorrhage (ICH); and 9%, subarachnoid hemorrhage (SAH). Of the hospitals, 31% provided inpatient stroke unit care. Ambulances were used in 56% of cases, and the median interval from onset to arrival was 4.5 hours. One-quarter of patients were referred from other hospitals. Intravenous thrombolysis (IVT) and endovascular treatment (EVT) rates were 11% and 4%, respectively. Three-quarters of the analyzed hospitals provided IVT and/or EVT, whereas 47% of hospitals providing IVT and 67% of hospitals providing EVT had less than one case per month. Decompressive surgery was performed on 28% of ICH patients, and clipping and coiling were performed in 17.2% and 14.3% of SAH patients, respectively. There were noticeable regional disparities between the various interventions, ambulance use, arrival time, and stroke unit availability. Conclusion This study describes the current status of acute stroke care in Korea. Despite quite acceptable quality of stroke care, it suggests regional and hospital disparities. Expansion of stroke units, stroke center certification or accreditation, and connections between stroke centers and emergency medical services are highly recommended. Graphical Abstract |
| Databáze: | OpenAIRE |
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