Real-World Impact of Modern Reperfusion Therapy for Acute Ischemic Stroke : A Nationwide Population-Based Data Study in Korea.

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of Korean Neurosurgical Society Pub Date : 2024-03-01 Epub Date: 2023-10-06 DOI:10.3340/jkns.2023.0133
Yung Ki Park, Byul-Hee Yoon, Yu Deok Won, Jae Hoon Kim, Hee In Kang
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Abstract

Objective: The treatment paradigm for acute ischemic stroke has undergone several major changes in the past decade, contributing to improved patient prognosis in clinical practice. However, the extent to which these changes have affected patient prognosis in the real-world is yet to be clarified. This study aimed to evaluate the real-world impact of modern reperfusion therapy for acute ischemic stroke using data from the National Health Insurance Service in Korea.

Methods: This study included patients aged 18-80 years who were admitted via the emergency room with an I63 code between 2011 and 2020. The rates of intravenous thrombolysis use and endovascular treatment according to the year of admission were investigated. Furthermore, the rates of decompressive craniectomy and 3-month mortality were also analyzed. The 10-year observational period was divided into three periods based on the 2015 guideline change as follows : prior, 2011-2014; transitional, 2015-2016; and modern, 2017-2020.

Results: A total of 307117 patients (mean age, 65.7±10.9 years) were included, and most patients were male (59.7%). The rate of endovascular treatment gradually increased during the study period from 0.71% in the prior period to 1.32% in the transitional period and finally to 1.85% in the modern period. Meanwhile, the 3-month mortality rate gradually decreased from 4.78% in the prior period to 4.03% in the transitional period and to 3.71% in the modern period.

Conclusion: In Korea, the mortality rate decreased as the rate of modern reperfusion therapy increased in patients with acute ischemic stroke. Overall, technical and scientific advances in reperfusion therapy have improved the outcome of patients with acute ischemic stroke in Korea.

现代再灌注治疗对急性缺血性中风的现实影响:韩国一项基于全国人口的数据研究。
目的:在过去的十年里,急性缺血性中风的治疗模式发生了几次重大变化,有助于在临床实践中改善患者的预后。然而,这些变化在现实世界中对患者预后的影响程度尚待澄清。本研究旨在利用韩国国家健康保险服务局(NHIS)的数据评估现代再灌注疗法对急性缺血性中风的现实影响。方法:本研究包括2011年至2020年间通过急诊室使用I63代码入院的18-80岁患者。根据入院年份调查静脉溶栓使用率和血管内治疗率。此外,还分析了开颅减压的发生率和3个月的死亡率。根据2015年指南的变化,10年的观察期分为三个阶段,如下:之前,2011-2014年;过渡期,2015-2016年;结果:共纳入307117名患者(平均年龄65.7±10.9岁),其中大多数患者为男性(59.7%)。血管内治疗率在研究期间从前期的0.71%逐渐上升到过渡期的1.32%,最终上升到现代的1.85%。同时,3个月死亡率从前期的4.78%逐渐下降到过渡期的4.03%和现代的3.71%。结论:在韩国,急性缺血性脑卒中患者的死亡率随着现代再灌注治疗率的提高而降低。总的来说,再灌注治疗的技术和科学进步改善了韩国急性缺血性中风患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
109
审稿时长
3-8 weeks
期刊介绍: The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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