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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  ;  Byung-Woo Yoon 
 BMC NEUROLOGY, Vol.11 : 2, 2011 
Journal Title
Issue Date
Aged ; Awareness* ; Brain Ischemia/diagnosis* ; Emergency Medical Services* ; Female ; Health Knowledge, Attitudes, Practice* ; Hospitalization ; Humans ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Regression Analysis ; Republic of Korea ; Stroke/diagnosis* ; Time Factors
Symptom Onset ; Acute Ischemic Stroke ; Emergency Medical Service ; Multivariable Logistic Regression Analysis ; Early Arrival
BACKGROUND: Delayed 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.

METHODS: A 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.

RESULTS: Among 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.

CONCLUSIONS: In 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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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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