Routing to Endovascular Treatment of Ischemic Stroke in Korea: Recognition of Need for Process Improvement
DC Field | Value | Language |
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dc.contributor.author | Kang, Jihoon | - |
dc.contributor.author | Kim, Seong-Eun | - |
dc.contributor.author | Park, Hong-Kyun | - |
dc.contributor.author | Cho, Yong-Jin | - |
dc.contributor.author | Kim, Jun Yup | - |
dc.contributor.author | Lee, Keon-Joo | - |
dc.contributor.author | Park, Jong-Moo | - |
dc.contributor.author | Park, Kwang-Yeol | - |
dc.contributor.author | Lee, Kyung Bok | - |
dc.contributor.author | Lee, Soo Joo | - |
dc.contributor.author | Lee, Ji Sung | - |
dc.contributor.author | Lee, Juneyoung | - |
dc.contributor.author | Yang, Ki Hwa | - |
dc.contributor.author | Choi, Ah Rum | - |
dc.contributor.author | Kang, Mi Yeon | - |
dc.contributor.author | Choi, Nack-Cheon | - |
dc.contributor.author | Gorelick, Philip B. | - |
dc.contributor.author | Bae, Hee Joon | - |
dc.date.accessioned | 2022-01-19T01:42:57Z | - |
dc.date.available | 2022-01-19T01:42:57Z | - |
dc.date.issued | 2020-10 | - |
dc.identifier.issn | 1011-8934 | - |
dc.identifier.issn | 1598-6357 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/53800 | - |
dc.description.abstract | Background: To track triage, routing, and treatment status regarding access to endovascular treatment (EVT) after acute ischemic stroke (AIS) at a national level. Methods: From national stroke audit data, potential candidates for EVT arriving within 6 hours with National Institute of Health Stroke Scale score of >= 7 were identified. Acute care hospitals were classified as thrombectomy-capable hospitals (TCHs, >= 15 EVT cases/year) or primary stroke hospital (PSH, < 15 cases/year), and patients' initial routes and subsequent inter-hospital transfer were described. Impact of initial routing to TCHs vs. PSHs on EVT and clinical outcomes were analyzed using multilevel generalized mixed effect models. Results: Out of 14,902 AIS patients, 2,180 (14.6%) were EVT candidates. Eighty-one percent of EVT candidates were transported by ambulance, but only one-third were taken initially to TCHs. Initial routing to TCHs was associated with greater chances of receiving EVT compared to initial routing to PSHs (33.3% vs 12.1%, P< 0.001; adjusted odds ratio (aOR), 2.21; 95% confidence interval [CI], 1.59-2.92) and favorable outcome (38.5% vs. 28.2%, P< 0.001; aOR, 1.52; 95% CI, 1.16-2.00). Inter-hospital transfers to TCHs occurred in 17.4% of those initially routed to a PSH and was associated with the greater chance of EVT compared to remaining at PSHs (34.8% vs. 7.5%, P < 0.001), but not with better outcomes. Conclusion: Two-thirds of EVT candidates were initially routed to PSHs despite greater chance of receiving EVT and having favorable outcomes if routed to a TCH in Korea. Process improvement is needed to direct appropriate patients to TCHs. | - |
dc.format.extent | 12 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | KOREAN ACAD MEDICAL SCIENCES | - |
dc.title | Routing to Endovascular Treatment of Ischemic Stroke in Korea: Recognition of Need for Process Improvement | - |
dc.title.alternative | Routing to Endovascular Treatment of Ischemic Stroke in Korea: Recognition of Need for Process Improvement | - |
dc.type | Article | - |
dc.identifier.doi | 10.3346/jkms.2020.35.e347 | - |
dc.identifier.bibliographicCitation | JOURNAL OF KOREAN MEDICAL SCIENCE, v.35, no.41, pp 1 - 12 | - |
dc.identifier.kciid | ART002638112 | - |
dc.description.isOpenAccess | Y | - |
dc.identifier.wosid | 000582510100003 | - |
dc.identifier.scopusid | 2-s2.0-85094868147 | - |
dc.citation.endPage | 12 | - |
dc.citation.number | 41 | - |
dc.citation.startPage | 1 | - |
dc.citation.title | JOURNAL OF KOREAN MEDICAL SCIENCE | - |
dc.citation.volume | 35 | - |
dc.type.docType | Article | - |
dc.publisher.location | 대한민국 | - |
dc.subject.keywordAuthor | Stroke | - |
dc.subject.keywordAuthor | Endovascular Treatment | - |
dc.subject.keywordAuthor | Stroke Center | - |
dc.subject.keywordAuthor | Organization | - |
dc.subject.keywordAuthor | Transfer | - |
dc.subject.keywordPlus | HEALTH-CARE PROFESSIONALS | - |
dc.subject.keywordPlus | INTRAVENOUS THROMBOLYSIS | - |
dc.subject.keywordPlus | EARLY MANAGEMENT | - |
dc.subject.keywordPlus | 2018 GUIDELINES | - |
dc.subject.keywordPlus | OUTCOMES | - |
dc.subject.keywordPlus | THROMBECTOMY | - |
dc.subject.keywordPlus | STATEMENT | - |
dc.subject.keywordPlus | CENTERS | - |
dc.subject.keywordPlus | SYSTEMS | - |
dc.relation.journalResearchArea | General & Internal Medicine | - |
dc.relation.journalWebOfScienceCategory | Medicine, General & Internal | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.description.journalRegisteredClass | kci | - |
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