"Cubic S Model": A for Early Recognition of Acute Ischemic Stroke Patients

ABSTRACT

PURPOSE: Delayed transfer to an appropriate emergency room has been the primary reason that patients with acute ischemic stroke do not receive thrombolytic therapy. Therefore, it is crucial to develop a catchphrase system to easily recognize acute ischemic stroke. In the course of developing catchphrases for public education or campaigns, we collected and analyzed actual expressions from patients with acute ischemic stroke or their witnesses. METHODS: From January 2007 to May 2009, we enrolled 1452 patients with acute ischemic stroke who were admitted to a neurology department via an emergency room. Subjective expressions of 3 domains, which consisted of temporal characteristics at onset, body-spatial location and neurologic symptoms, were classified and the frequencies of "words" or "short phrases" were evaluated. RESULTS: In the expressions of patients with transient ischemic attack or mild stroke, "sudden" (71.1%) was the most frequent in terms of temporal characteristics at onset and was followed by "after awakening" (42.7%) and "as unusual" (7.4%). When expressing body-spatial location, "one-side arm" (51.5%), "one-side leg" (42.5%) or "onesided face" (12.5%) followed, with frequent expression of neurological symptoms of motor-parts (13.4%), speechparts (7.1%) and sensory-parts (6.7%). Patients with NIHSS > or =6 showed the same rank of expressions related to temporal and body-spatial domains. Regarding neurological symptoms, however, motor-part (74.2%), consciousness-part (50.1%) and speech-part (50.0%) were more frequent. CONCLUSION: We propose a novel Korean catchphrase, "Sudden Side Symptoms", based on a 3-dimensional system (Cubic S model) for public education so people will more easily recognize acute ischemic strokes.