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Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room

OBJECTIVE: With the recent increase in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the role of neurosurgeons in AIS treatment has become increasingly important. This study aimed to assess the outcomes of patients with AIS treated by neurosurgeons and neurologists in the emergency r...

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Autores principales: Lee, Sang Hyuk, Nam, Taek Min, Jang, Ji Hwan, Kim, Young Zoon, Kim, Kyu Hong, Ryu, Kyeong Hwa, Kim, Do-Hyung, Kwan, Byung Soo, Lee, Hyungon, Kim, Seung Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurosurgical Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837491/
https://www.ncbi.nlm.nih.gov/pubmed/35974432
http://dx.doi.org/10.3340/jkns.2022.0085
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author Lee, Sang Hyuk
Nam, Taek Min
Jang, Ji Hwan
Kim, Young Zoon
Kim, Kyu Hong
Ryu, Kyeong Hwa
Kim, Do-Hyung
Kwan, Byung Soo
Lee, Hyungon
Kim, Seung Hwan
author_facet Lee, Sang Hyuk
Nam, Taek Min
Jang, Ji Hwan
Kim, Young Zoon
Kim, Kyu Hong
Ryu, Kyeong Hwa
Kim, Do-Hyung
Kwan, Byung Soo
Lee, Hyungon
Kim, Seung Hwan
author_sort Lee, Sang Hyuk
collection PubMed
description OBJECTIVE: With the recent increase in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the role of neurosurgeons in AIS treatment has become increasingly important. This study aimed to assess the outcomes of patients with AIS treated by neurosurgeons and neurologists in the emergency room (ER) of a tertiary hospital in South Korea. METHODS: From January 2020 to June 2021, 536 patients with AIS within 24 hours of symptom onset were admitted to our hospital via the ER. Based on the type of doctors who provided initial care for AIS in the ER, patients were divided into two groups : (a) neurosurgeon group (n=119, 22.2%) and (b) neurologist group (n=417, 77.8%). RESULTS: Intravenous tissue plasminogen activator (tPA) was administered in 82 (15.3%) of 536 patients (n=17 [14.3%] in the neurosurgeon group and n=65 [15.6%] in the neurologist group). The door-to-tPA time was not significantly different between both groups (median, 53 minutes; interquartile range [IQR], 45–58 vs. median, 54 minutes; IQR, 46–74; p=0.372). MT was performed in 69 patients (12.9%) (n=25, 36.2% in the neurosurgeon group and n=44, 63.8% in the neurologist group). The neurosurgeon group achieved a shorter door-to-puncture time than the neurologist group (median, 115 minutes; IQR, 107–151 vs. median, 162 minutes; IQR, 117–189; p=0.049). Good clinical outcomes (3-month modified Rankin Scale 0–2) did not differ significantly between the two groups (96/119 [80.7%] vs. 322/417 [77.2%], p=0.454). CONCLUSION: The neurosurgeon group showed similar door-to-treatment time and clinical outcomes to the neurologist group in patients with AIS in the ER. This study suggests that neurosurgeons have comparable abilities to care for patients with AIS in the ER.
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spelling pubmed-98374912023-01-23 Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room Lee, Sang Hyuk Nam, Taek Min Jang, Ji Hwan Kim, Young Zoon Kim, Kyu Hong Ryu, Kyeong Hwa Kim, Do-Hyung Kwan, Byung Soo Lee, Hyungon Kim, Seung Hwan J Korean Neurosurg Soc Clinical Article OBJECTIVE: With the recent increase in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the role of neurosurgeons in AIS treatment has become increasingly important. This study aimed to assess the outcomes of patients with AIS treated by neurosurgeons and neurologists in the emergency room (ER) of a tertiary hospital in South Korea. METHODS: From January 2020 to June 2021, 536 patients with AIS within 24 hours of symptom onset were admitted to our hospital via the ER. Based on the type of doctors who provided initial care for AIS in the ER, patients were divided into two groups : (a) neurosurgeon group (n=119, 22.2%) and (b) neurologist group (n=417, 77.8%). RESULTS: Intravenous tissue plasminogen activator (tPA) was administered in 82 (15.3%) of 536 patients (n=17 [14.3%] in the neurosurgeon group and n=65 [15.6%] in the neurologist group). The door-to-tPA time was not significantly different between both groups (median, 53 minutes; interquartile range [IQR], 45–58 vs. median, 54 minutes; IQR, 46–74; p=0.372). MT was performed in 69 patients (12.9%) (n=25, 36.2% in the neurosurgeon group and n=44, 63.8% in the neurologist group). The neurosurgeon group achieved a shorter door-to-puncture time than the neurologist group (median, 115 minutes; IQR, 107–151 vs. median, 162 minutes; IQR, 117–189; p=0.049). Good clinical outcomes (3-month modified Rankin Scale 0–2) did not differ significantly between the two groups (96/119 [80.7%] vs. 322/417 [77.2%], p=0.454). CONCLUSION: The neurosurgeon group showed similar door-to-treatment time and clinical outcomes to the neurologist group in patients with AIS in the ER. This study suggests that neurosurgeons have comparable abilities to care for patients with AIS in the ER. Korean Neurosurgical Society 2023-01 2022-08-17 /pmc/articles/PMC9837491/ /pubmed/35974432 http://dx.doi.org/10.3340/jkns.2022.0085 Text en Copyright © 2023 The Korean Neurosurgical Society 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 (http://creativecommons.org/licenses/by-nc/4.0 (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 Clinical Article
Lee, Sang Hyuk
Nam, Taek Min
Jang, Ji Hwan
Kim, Young Zoon
Kim, Kyu Hong
Ryu, Kyeong Hwa
Kim, Do-Hyung
Kwan, Byung Soo
Lee, Hyungon
Kim, Seung Hwan
Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room
title Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room
title_full Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room
title_fullStr Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room
title_full_unstemmed Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room
title_short Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room
title_sort role of neurosurgeons in the treatment of acute ischemic stroke in the emergency room
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837491/
https://www.ncbi.nlm.nih.gov/pubmed/35974432
http://dx.doi.org/10.3340/jkns.2022.0085
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