Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea

Park Eun Hye; Gil Yong Jin; Kim Chanki; Kim Beom Joon; Hwang Seung-sik

doi:10.3961/jpmph.21.329

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자료유형: 학술저널

저자정보: Park Eun Hye (Department of Preventive Medicine Graduate School of Public Health Seoul National University) Gil Yong Jin (Department of Preventive Medicine Graduate School of Public Health Seoul National University) Kim Chanki (Department of Preventive Medicine Graduate School of Public Health Seoul National University) Kim Beom Joon (Department of Neurology Seoul National University Bundang Hospital SeongnamKorea) Hwang Seung-sik (Department of Preventive Medicine Graduate School of Public Health Seoul National University)

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제54권 제6호

발행연도: 2021.11

수록면: 385 - 394 (10page)

DOI: 10.3961/jpmph.21.329

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Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs).Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression.Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS.Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

#Ischemic stroke #Thrombectomy #Small-area analysis #Health service area

참고문헌 (34)

참고문헌 신청

통계청 인구동향과 / 2020 / 2018년 사망원인통계 / 대한의사협회지 63(5):286~297

Jun Yup Kim / 2020 / Acute Stroke Care in Korea in 2013–2014: National Averages and Disparities / Journal of Korean Medical Science 35(20):1~13

이솔암 / 2020 / Incidence, Risk Factors, and Prediction of Myocardial Infarction and Stroke in Farmers: A Korean Nationwide Population-based Study / 예방의학회지 53(5):313~322

Jun Yup Kim / 2019 / Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society / 대한뇌졸중학회지 21(1):42~59

Goyal M / 2015 / Randomized assessment of rapid endovascular treatment of ischemic stroke / N Engl J Med 372(11):1019~1030

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