Urban-Rural Gap in the Prehospital Delay of Acute Stroke Patients
Journal of the Korean Society of Emergency Medicine
;
: 664-673, 2013.
Article
in Korean
| WPRIM
| ID: wpr-98223
ABSTRACT
PURPOSE:
The aim of this study was to compare the difference in acute stroke management between urban and rural areas, to investigate the factors affecting these differences, and to acquire basic information for establishing an efficient regional hub and spoke system for stroke patients.METHODS:
This retrospective study was based on adult patients diagnosed with acute ischemic stroke from January 2012 to December 2012 at a regional cerebrovascular center. The term "acute" was defined as 24 hours from symptom recognized. The term "urban" was defined as the region within the boundary of a metropolitan area. The distance from the symptom onset location to the stroke center was calculated using a global positioning system.RESULTS:
The rate of arriving at a stroke center within 3 hours after stroke recognition for acute ischemic stroke patients was much higher in urban areas compared to rural areas (27.5 vs. 19.2%, respectively; p-value=0.011). In stroke cases in rural areas, the distance from symptom onset location to a stroke center was determined as statistically significant through multivariate logistic regression analysis (Odds ratio (OR), 0.982; 95% Confidence interval (CI) 0.969-0.995). In contrast, the use of a public ambulance (OR, 4.258; 95% CI 2.233-8.118) and inter-hospital transfer (OR, 0.416; 95% CI 0.216-0.800) were the main prehospital delay factors in urban areas.CONCLUSION:
For stroke cases in urban areas, it was important to directly visit a stroke center without transfer using a public ambulance. For rural areas, a new hub hospital and policies are necessary for reducing prehospital delay.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Logistic Models
/
Retrospective Studies
/
Ambulances
/
Stroke
/
Geographic Information Systems
/
Emergency Medical Services
Type of study:
Observational study
/
Risk factors
Limits:
Adult
/
Humans
Language:
Korean
Journal:
Journal of the Korean Society of Emergency Medicine
Year:
2013
Type:
Article
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