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Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea
BACKGROUND: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed bet...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Academy of Medical Sciences
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623032/ https://www.ncbi.nlm.nih.gov/pubmed/36325609 http://dx.doi.org/10.3346/jkms.2022.37.e305 |
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author | Kim, Dae-Hyun Moon, Seok-Joo Lee, Juneyoung Cha, Jae-Kwan Kim, Moo Hyun Park, Jong-Sung Ban, Byeolnim Kang, Jihoon Kim, Beom Joon Kim, Won-Seok Yoon, Chang-Hwan Lee, Heeyoung Kim, Seongheon Kang, Eun Kyoung Her, Ae-Young Yoon, Cindy W Rha, Joung-Ho Woo, Seong-Ill Lee, Won Kyung Jung, Han-Young Lee, Jang Hoon Park, Hun Sik Hwang, Yang-Ha Kim, Keonyeop Kim, Rock Bum Choi, Nack-Cheon Hwang, Jinyong Park, Hyun-Woong Park, Ki Soo Yi, SangHak Cho, Jae Young Kim, Nam-Ho Choi, Kang-Ho Kim, Juhan Han, Jae-Young Choi, Jay Chol Kim, Song-Yi Choi, Joon-Hyouk Kim, Jei Sohn, Min Kyun Choi, Si Wan Shin, Dong-Ick Lee, Sang Yeub Bae, Jang-Whan Lee, Kun Sei Bae, Hee-Joon |
author_facet | Kim, Dae-Hyun Moon, Seok-Joo Lee, Juneyoung Cha, Jae-Kwan Kim, Moo Hyun Park, Jong-Sung Ban, Byeolnim Kang, Jihoon Kim, Beom Joon Kim, Won-Seok Yoon, Chang-Hwan Lee, Heeyoung Kim, Seongheon Kang, Eun Kyoung Her, Ae-Young Yoon, Cindy W Rha, Joung-Ho Woo, Seong-Ill Lee, Won Kyung Jung, Han-Young Lee, Jang Hoon Park, Hun Sik Hwang, Yang-Ha Kim, Keonyeop Kim, Rock Bum Choi, Nack-Cheon Hwang, Jinyong Park, Hyun-Woong Park, Ki Soo Yi, SangHak Cho, Jae Young Kim, Nam-Ho Choi, Kang-Ho Kim, Juhan Han, Jae-Young Choi, Jay Chol Kim, Song-Yi Choi, Joon-Hyouk Kim, Jei Sohn, Min Kyun Choi, Si Wan Shin, Dong-Ick Lee, Sang Yeub Bae, Jang-Whan Lee, Kun Sei Bae, Hee-Joon |
author_sort | Kim, Dae-Hyun |
collection | PubMed |
description | BACKGROUND: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. METHODS: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. RESULTS: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI; additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. CONCLUSIONS: Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS. |
format | Online Article Text |
id | pubmed-9623032 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Korean Academy of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-96230322022-11-04 Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea Kim, Dae-Hyun Moon, Seok-Joo Lee, Juneyoung Cha, Jae-Kwan Kim, Moo Hyun Park, Jong-Sung Ban, Byeolnim Kang, Jihoon Kim, Beom Joon Kim, Won-Seok Yoon, Chang-Hwan Lee, Heeyoung Kim, Seongheon Kang, Eun Kyoung Her, Ae-Young Yoon, Cindy W Rha, Joung-Ho Woo, Seong-Ill Lee, Won Kyung Jung, Han-Young Lee, Jang Hoon Park, Hun Sik Hwang, Yang-Ha Kim, Keonyeop Kim, Rock Bum Choi, Nack-Cheon Hwang, Jinyong Park, Hyun-Woong Park, Ki Soo Yi, SangHak Cho, Jae Young Kim, Nam-Ho Choi, Kang-Ho Kim, Juhan Han, Jae-Young Choi, Jay Chol Kim, Song-Yi Choi, Joon-Hyouk Kim, Jei Sohn, Min Kyun Choi, Si Wan Shin, Dong-Ick Lee, Sang Yeub Bae, Jang-Whan Lee, Kun Sei Bae, Hee-Joon J Korean Med Sci Original Article BACKGROUND: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. METHODS: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. RESULTS: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI; additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. CONCLUSIONS: Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS. The Korean Academy of Medical Sciences 2022-10-05 /pmc/articles/PMC9623032/ /pubmed/36325609 http://dx.doi.org/10.3346/jkms.2022.37.e305 Text en © 2022 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Dae-Hyun Moon, Seok-Joo Lee, Juneyoung Cha, Jae-Kwan Kim, Moo Hyun Park, Jong-Sung Ban, Byeolnim Kang, Jihoon Kim, Beom Joon Kim, Won-Seok Yoon, Chang-Hwan Lee, Heeyoung Kim, Seongheon Kang, Eun Kyoung Her, Ae-Young Yoon, Cindy W Rha, Joung-Ho Woo, Seong-Ill Lee, Won Kyung Jung, Han-Young Lee, Jang Hoon Park, Hun Sik Hwang, Yang-Ha Kim, Keonyeop Kim, Rock Bum Choi, Nack-Cheon Hwang, Jinyong Park, Hyun-Woong Park, Ki Soo Yi, SangHak Cho, Jae Young Kim, Nam-Ho Choi, Kang-Ho Kim, Juhan Han, Jae-Young Choi, Jay Chol Kim, Song-Yi Choi, Joon-Hyouk Kim, Jei Sohn, Min Kyun Choi, Si Wan Shin, Dong-Ick Lee, Sang Yeub Bae, Jang-Whan Lee, Kun Sei Bae, Hee-Joon Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea |
title | Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea |
title_full | Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea |
title_fullStr | Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea |
title_full_unstemmed | Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea |
title_short | Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea |
title_sort | comparison of factors associated with direct versus transferred-in admission to government-designated regional centers between acute ischemic stroke and myocardial infarction in korea |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623032/ https://www.ncbi.nlm.nih.gov/pubmed/36325609 http://dx.doi.org/10.3346/jkms.2022.37.e305 |
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