Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Cindy W. Yoon, Hoonji Oh, Juneyoung Lee, Joung Ho Rha, Seong Ill Woo, Won Kyung Lee, Han Young Jung, Byeolnim Ban, Jihoon Kang, Beom Joon Kim, Won Seok Kim, Chang Hwan Yoon, Heeyoung Lee, Seongheon Kim, Sung Hun Kim, Eun Kyoung Kang, Ae Young Her, Jae Kwan Cha, Dae Hyun Kim, Moo Hyun KimJang Hoon Lee, Hun Sik Park, Keonyeop Kim, Rock Bum Kim, Nack Cheon Choi, Jinyong Hwang, Hyun Woong Park, Ki Soo Park, Sanghak Yi, Jae Young Cho, Nam Ho Kim, Kang Ho Choi, Yongcheol Kim, Juhan Kim, Jae Young Han, Jay Chol Choi, Song Yi Kim, Joon Hyouk Choi, Jei Kim, Sung Ju Jee, Min Kyun Sohn, Si Wan Choi, Dong Ick Shin, Sang Yeub Lee, Jang Whan Bae, Kunsei Lee, Hee Joon Bae

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

BACKGROUND: Prehospital delay is an important contributor to poor outcomes in both acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We aimed to compare the prehospital delay and related factors between AIS and AMI. METHODS AND RESULTS: We identified patients with AIS and AMI who were admitted to the 11 Korean Regional Cardiocerebrovascular Centers via the emergency room between July 2016 and December 2018. Delayed arrival was defined as a prehospital delay of >3 hours, and the generalized linear mixed-effects model was applied to explore the effects of potential predictors on delayed arrival. This study included 17 895 and 8322 patients with AIS and AMI, respectively. The median value of prehospital delay was 6.05 hours in AIS and 3.00 hours in AMI. The use of emergency medical services was the key determinant of delayed arrival in both groups. Previous history, 1-person household, weekday presentation, and interhospital transfer had higher odds of delayed arrival in both groups. Age and sex had no or minimal effects on delayed arrival in AIS; however, age and female sex were associated with higher odds of delayed arrival in AMI. More severe symptoms had lower odds of delayed arrival in AIS, whereas no significant effect was observed in AMI. Off-hour presentation had higher and prehospital awareness had lower odds of delayed arrival; however, the magnitude of their effects differed quantitatively between AIS and AMI. CONCLUSIONS: The effects of some nonmodifiable and modifiable factors on prehospital delay differed between AIS and AMI. A differentiated strategy might be required to reduce prehospital delay.

Original languageEnglish
Article numbere023214
JournalJournal of the American Heart Association
Volume11
Issue number9
DOIs
StatePublished - 3 May 2022

Keywords

  • acute ischemic stroke
  • acute myocardial infarction
  • prehospital delay

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