| 서울대학교병원 응급실을 방문하였던 급성 뇌졸중 환자들의 도착시간 관련요인에 관한 연구 |
| 조용진, 박병주* , 윤병우, 정재면, 조진환, 노재규 |
| 서울대학교 의과대학 신경과학교실, 서울대학교 의과대학 예방의학교실 |
| Factors related to Hospital Arrival Time of Acute Stroke Patients Who Visit Seoul National University Hospital |
| Y. J. Cho, M.D., B. J. Park, M.D. *, B. W. Yoon, M.D., J. M. Chung, M.D., J. H. Cho, M.D., J. K. Rho, M.D. |
| Seoul National University Hospital, College of Medicine, Department of Neurology
Seoul National University, College of Medicine, Department of Preventive Medicine* |
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| Abstract |
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Background & Objectives : Stroke Is a leading cause of death and disability in Korea. The management for the stroke should be given as soon as possible to be effective. We analyzed the factors which are related to the time of hospital arrival following acute stroke. Methods : We performed a prospective study using "Protocol of Acute Stroke in SNUH" in the patients who visited our hospital within 72 hours after the onset of stroke from 1 August 1994 to 31 July 1995, The protocol included demographic variables, educational level, history of previous stroke, transportation method, symptom at onset, stroke subtype, distance from the place where stroke occurred to hospital, and the interval from stroke onset to hospital arrival. Also we asked whether the patient was previously educated about stroke and whether the patient visited other hospital before arriving at SNUH. Results : In 168 patients who fulfilled the criteria, 67 (39.9%) presented to hospital within 6 hours. Early hospital arrival after stroke was influenced by the transportation method, distance from the hospital, impairment of consciousness, stroke subtype and prior visit to other hospital. Hospital arrival was earliest in patients using 119 emergency transportation system (p<0.05) . The patients who developed stroke remote from hospital, who arrived emergency room by way of other hospital, who showed no impairment of consciousness, and whose stroke subtype was infarction arrived at the hospital late (p<0.05) . Age, gender, season, and quarter of a day had no significant effect on arrival time. But the patients who had high educational level, who had suffered from previous stroke and who had had previous education about stroke also didn't arrive sooner. In using multiple regression analysis, distance to the hospital, stroke subtype, transportation method and age influenced the hospital arrival time significantly, and the R2 value, which is explanation power, was 24.1%. Conclusion : Our results suggest that 119 emergency transportation system did a role to achieve an early hospital arrival following acute stroke. And also suggest that continuous and effective education about stroke to the patients and the public would be highly necessary. |
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