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급성 뇌혈관 질환이 의심되는 환자에서 병원도착 지연요인

Other Titles
 Factors in Delayed Arrival at the Emergency Department in Patients with Suspected Acute Stroke 
Authors
 이신호  ;  박유석  ;  정성필  ;  박인철  ;  정현수  ;  최선행  ;  장문준 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.17(5) : 431-437, 2006 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2006
Keywords
Cerebrovascular Accident ; Time Factors ; Emergenics departments
Abstract
Purpose: Acute stroke is a leading cause of serious, long-term disability and mortality in Korea. Two major refractory problems limiting effective stroke management are patient delays in recognizing stroke symptoms and reluctance to take action. The purpose of this study was to evaluate the factors influencing delayed arrival at the hospital in patients with suspected acute stroke. Methods: One hundred and seventy-one patients with symptoms of acute stroke who presented to the emergency department (ED) between November 2004 and April 2005 were enrolled in the study. A questionnaire prospectively surveyed by emergency medicine residents was used in evaluating patients for inclusion. Results: Fifty-eight patients (34% of the total) arrived at the hospital within 3 hours of symptom onset. As suggested by univariate analysis, initial symptoms (mental change and speech disturbance), presence or absence of bystanders at the time of symptom onset, utilization of an emergency medical service (EMS) system and inter-hospital transfer all seemed to be associated with the time interval between detection and ED arrival. Further evaluation using multiple linear regression indicated that severity of initial neurologic symptoms, use of EMS transport, the necessity of inter-hospital transfer, and score on the abnormal Los Angeles Prehospital Stroke Scale (LAPSS) were statistically significant factors affecting arrival time. Conclusion: Factors that were associated with earlier ED arrival were severe initial symptoms, utilization of the EMS system, direct arrival from the site of symptom onset, and abnormal LAPSS. Therefore, continuous public education and paramedic training is required to promote early detection and delivery of patients with acute stroke to an appropriate facility.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109982
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