• Bmc Neurol · Jan 2011

    Multicenter Study

    Stroke awareness decreases prehospital delay after acute ischemic stroke in Korea.

    • Young Seo Kim, Sang-Soon Park, Hee-Joon Bae, A-Hyun Cho, Yong-Jin Cho, Moon-Ku Han, Ji Hoe Heo, Kyusik Kang, Dong-Eog Kim, Hahn Young Kim, Gyeong-Moon Kim, Sun Uk Kwon, Hyung-Min Kwon, Byung-Chul Lee, Kyung Bok Lee, Seung-Hoon Lee, Su-Ho Lee, Yong-Seok Lee, Hyo Suk Nam, Mi-Sun Oh, Jong-Moo Park, Joung-Ho Rha, Kyung-Ho Yu, and Byung-Woo Yoon.
    • Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
    • Bmc Neurol. 2011 Jan 1;11:2.

    BackgroundDelayed 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.MethodsA 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.ResultsAmong 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.ConclusionsIn 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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