Acute Stroke Care in Korea in 2013-2014: National Averages and Disparities

Overview

Journal J Korean Med Sci

Specialty General Medicine

Date 2020 May 26

PMID 32449325

Citations 15

Authors

Jun Yup Kim

Keon Joo Lee

Jihoon Kang

Beom Joon Kim

Seong Eun Kim

Hyunji Oh

Hong Kyun Park

Yong Jin Cho

Jong Moo Park

Kwang Yeol Park

Kyung Bok Lee

Soo Joo Lee

Tackeun Kim

Ji Sung Lee

Juneyoung Lee

Ki Hwa Yang

Ah Rum Choi

Mi Yeon Kang

Hee Joon Bae

Affiliations

Soon will be listed here.

Abstract

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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