title: Factors Associated with Early Hospital Arrival in Patients with Acute Ischemic Stroke.
abstract: OBJECTIVE
  Factors associated with early arrival may vary according to the characteristics of the hospital. We investigated the factors associated with early hospital arrival in two different stroke centers located in Korea and Japan.
  
  
  METHODS
  Consecutive patients with ischemic stroke arrived hospital within 48 hours of onset between January 2011 and December 2012 were identified and the clinical and time variables were retrieved from the prospective stroke registries of Severance Hospital of Yonsei University Health System (YUHS; Seoul, Korea) and National Cerebral and Cardiovascular Center (NCVC; Osaka, Japan). Subjects were dichotomized into early (time from onset to arrival ≤4.5 hours) and late (>4.5 hours) arrival groups. Univariate and multivariate analyses were performed to evaluate factors associated with early hospital arrival.
  
  
  RESULTS
  A total of 1,966 subjects (992 from YUHS; 974 from NCVC) were included in this study. The median time from onset to arrival was 6.1 hours [interquartile range, 1.7-17.8 hours]. In multivariate analysis, the factors associated with early arrival were atrial fibrillation (Odds ratio [OR], 1.505; 95% confidence interval [CI], [1.168-1.939]), higher initial National Institute of Health Stroke Scale scores (OR, 1.037; 95% CI [1.023-1.051]), onset during daytime (OR, 2.799; 95% CI [2.173-3.605]), and transport by an emergency medical service (OR, 2.127; 95% CI [1.700-2.661]). These factors were consistently associated with early arrival in both hospitals.
  
  
  CONCLUSIONS
  Despite differences between the hospitals, there were common factors related to early arrival. Efforts to identify and modify these factors may promote early hospital arrival and improve stroke outcome.
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dongbeom
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Eijirou
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kijeong
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagatsuka
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
keywords: Acute stroke therapy; Cerebral infarction; Countries; Early hospital arrival; Emergency medical service; Prehospital delay