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KMID : 0191120200350200167
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Journal of Korean Medical Science
2020 Volume.35 No. 20 p.167 ~ p.167
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Acute Stroke Care in Korea in 2013?2014: National Averages and Disparities
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Kim Jun-Yup
Lee Keon-Joo
Kang Ji-Hoon
Kim Beom-Joon
Kim Seong-Eun
Oh Hyun-Ji
Park Hong-Kyun
Cho Yong-Jin
Park Jong-Moo
Park Kwang-Yeol
Lee Kyung-Bok
Lee Soo-Joo
Kim Tackeun
Lee Ji-Sung
Lee June-Young
Yang Ki-Hwa
Choi Ah-Rum
Kang Mi-Yeon
Bae Hee-Joon
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Abstract
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Background: This study aimed to describe the current status of acute stroke care in Korea and explore disparities among hospitals and regions.
Methods: The 2013 and 2014 national stroke audit data and the national health insurance claims data were linked and used for this study. Stroke patients hospitalized via emergency rooms within 7 days of stroke onset were selected.
Results: A total of 19,608 patients treated in 216 hospitals were analyzed. Among them 76% had ischemic stroke; 15%, intracerebral hemorrhage (ICH); and 9%, subarachnoid hemorrhage (SAH). Of the hospitals, 31% provided inpatient stroke unit care. Ambulances were used in 56% of cases, and the median interval from onset to arrival was 4.5 hours. One-quarter of patients were referred from other hospitals. Intravenous thrombolysis (IVT) and endovascular treatment (EVT) rates were 11% and 4%, respectively. Three-quarters of the analyzed hospitals provided IVT and/or EVT, whereas 47% of hospitals providing IVT and 67% of hospitals providing EVT had less than one case per month. Decompressive surgery was performed on 28% of ICH patients, and clipping and coiling were performed in 17.2% and 14.3% of SAH patients, respectively. There were noticeable regional disparities between the various interventions, ambulance use, arrival time, and stroke unit availability.
Conclusion: This study describes the current status of acute stroke care in Korea. Despite quite acceptable quality of stroke care, it suggests regional and hospital disparities. Expansion of stroke units, stroke center certification or accreditation, and connections between stroke centers and emergency medical services are highly recommended.
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KEYWORD
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Stroke, Epidemiology, Cerebral Infarction, Cerebral Hemorrhage, Subarachnoid Hemorrhage
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