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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Factors Associated With the Hospital Arrival Time in Patients With Ischemic Stroke in Korea
Jeongha Sim1, Cha-Nam Shin, Kyungeh An
1Jeongha Sim, PhD, RN Assistant Professor, Department of Nursing, Jeonju University, South Korea. Cha-Nam Shin, PhD, RN Assistant Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix. Kyungeh An, PhD, RN Associate Professor, College of Nursing, Virginia Commonwealth University, Richmond. Michael Todd, PhD Associate Research Professor, College of Nursing Health Innovation, Arizona State University, Phoenix.
Insights
Rural Korean stroke patients face longer hospital delays due to demographic and access factors. Public awareness campaigns and targeted strategies are crucial to reduce prehospital delays for ischemic stroke care.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Stroke is a major cause of death and disability in Korea.
- Ischemic stroke patients often miss the critical 3-hour window for treatment due to delayed hospital arrival.
Purpose of the Study:
- Compare urban vs. rural ischemic stroke patients in Korea.
- Identify factors influencing prehospital delay in stroke patients.
Main Methods:
- Cross-sectional, descriptive study.
- Structured survey of 229 ischemic stroke patients in Korea.
Main Results:
- Rural patients were older, less educated, lower income, and had longer transport times.
- Factors associated with faster arrival included emergency room visits, ambulance use, and clear stroke symptoms.
Conclusions:
- Public awareness of stroke symptoms needs enhancement nationwide.
- Strategies to reduce prehospital delays are essential, especially for rural populations.
Background:
Stroke is a leading cause of death and disability among the Korean population. Ischemic stroke patients tend to delay arrival at the hospital and often miss the "golden" 3-hour window, which is optimal for tissue plasminogen activator treatment.
Objective:
The purposes of this study were to compare demographic, clinical/behavioral, and sociocultural characteristics of ischemic stroke patients who reside in urban and rural areas of Korea and to identify factors contributing to the time taken from symptom onset to hospital arrival.
Methods:
A cross-sectional, descriptive study was conducted using a structured survey in a convenience sample of 229 ischemic stroke patients in Korea.
Results:
Individuals who resided in rural areas were more likely to be female, older, less educated; had lower incomes; contacted adult children at the onset of stroke; and took a longer time to be transported to a hospital than did those who resided in urban areas (P < .05). Patients who visited an emergency room, transferred via an ambulance, contacted emergency medical services, perceived symptoms as serious, had a family history of stroke, or experienced hemiparesis as the primary stroke symptom arrived at the hospital relatively sooner, whereas patients who experienced unclear symptoms took relatively more time to arrive at the hospital following symptom onset (P < .05).
Conclusions:
Nationwide efforts are needed to promote public awareness of stroke and to develop strategies to reduce prehospital delay time for ischemic stroke patients, particularly those who reside in rural areas in Korea.
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