• Jay Chol Choi, Joong Goo Kim, Chul Hoo Kang, Hee Joon Bae, Jihoon Kang, Soo Joo Lee, Jong Moo Park, Tai Hwan Park, Yong Jin Cho, Kyung Bok Lee, Jun Lee, Dong Eog Kim, Jae Kwan Cha, Joon Tae Kim, Byung Chul Lee, Ji Sung Lee, and Anthony S Kim.
• Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea.
• J. Korean Med. Sci. 2021 Mar 22; 36 (11): e77.

BackgroundWe investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke.MethodsWe identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society.ResultsOf 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time (P = 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes.ConclusionThe use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time.© 2021 The Korean Academy of Medical Sciences.

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