title: Stroke awareness decreases prehospital delay after acute ischemic stroke in Korea.
abstract: BACKGROUND
  Delayed arrival at hospital is one of the major obstacles in enhancing the rate of thrombolysis therapy in patients with acute ischemic stroke. Our study aimed to investigate factors associated with prehospital delay after acute ischemic stroke in Korea.
  
  
  METHODS
  A prospective, multicenter study was conducted at 14 tertiary hospitals in Korea from March 2009 to July 2009. We interviewed 500 consecutive patients with acute ischemic stroke who arrived within 48 hours. Univariate and multivariate analyses were performed to evaluate factors influencing prehospital delay.
  
  
  RESULTS
  Among the 500 patients (median 67 years, 62% men), the median time interval from symptom onset to arrival was 474 minutes (interquartile range, 170-1313). Early arrival within 3 hours of symptom onset was significantly associated with the following factors: high National Institutes of Health Stroke Scale (NIHSS) score, previous stroke, atrial fibrillation, use of ambulance, knowledge about thrombolysis and awareness of the patient/bystander that the initial symptom was a stroke. Multivariable logistic regression analysis indicated that awareness of the patient/bystander that the initial symptom was a stroke (OR 4.438, 95% CI 2.669-7.381), knowledge about thrombolysis (OR 2.002, 95% CI 1.104-3.633) and use of ambulance (OR 1.961, 95% CI 1.176-3.270) were significantly associated with early arrival.
  
  
  CONCLUSIONS
  In Korea, stroke awareness not only on the part of patients, but also of bystanders, had a great impact on early arrival at hospital. To increase the rate of thrombolysis therapy and the incidence of favorable outcomes, extensive general public education including how to recognize stroke symptoms would be important.
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Young Seo
authors.initials: YS
authors.lastname: Kim
authors.forename: Sang-Soon
authors.initials: SS
authors.lastname: Park
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
authors.forename: A-Hyun
authors.initials: AH
authors.lastname: Cho
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Cho
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
authors.forename: Kyusik
authors.initials: K
authors.lastname: Kang
authors.forename: Dong-Eog
authors.initials: DE
authors.lastname: Kim
authors.forename: Hahn Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Gyeong-Moon
authors.initials: GM
authors.lastname: Kim
authors.forename: Sun Uk
authors.initials: SU
authors.lastname: Kwon
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Kwon
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Lee
authors.forename: Kyung Bok
authors.initials: KB
authors.lastname: Lee
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Su-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Lee
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Nam
authors.forename: Mi-Sun
authors.initials: MS
authors.lastname: Oh
authors.forename: Jong-Moo
authors.initials: JM
authors.lastname: Park
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Rha
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Yoon
mesh_terms: D000368:Aged; D001364:Awareness; D002545:Brain Ischemia / Q000175:diagnosis*; D004632:Emergency Medical Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012044:Regression Analysis; D056910:Republic of Korea; D020521:Stroke / Q000175:diagnosis*; D013997:Time Factors