Improving the Clinical Outcome in Stroke Patients Receiving Thrombolytic or Endovascular Treatment in Korea: from the SECRET Study
- 주제(키워드) reperfusion , therapy , ischemic stroke , outcome
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kim, Young Dae; Heo, Ji Hoe; Yoo, Joonsang; Park, Hyungjong; Heo, JoonNyung; Kim, Minyoung; Choi, Jin Kyo; Nam, Hyo Suk] Yonsei Univ, Dept Neurol, Coll Med, Seoul 03722, South Korea; [Yoo, Joonsang; Park, Hyungjong; Sohn, Sung-Il; Hong, Jeong-Ho] Keimyung Univ, Brain Res Inst, Dept Neurol, Sch Med, Daegu 41931, South Korea; [Kim, Byung Moon; Kim, Dong Joon] Yonsei Univ, Dept Radiol, Coll Med, Seoul 03722, South Korea; [Bang, Oh Young; Seo, Woo-Keun; Chung, Jong-Won] Sungkyunkwan Univ, Dept Neurol, Samsung Med Ctr, Sch Med, Seoul 06351, South Korea; [Kim, Hyeon Chang] Yonsei Univ, Dept Prevent Med, Coll Med, Seoul 03722, South Korea; [Han, Euna] Yonsei Univ, Yonsei Inst Pharmaceut Res, Coll Pharm, Incheon 21983, South Korea; [Lee, Kyung-Yul; Kim, Jinkwon] Yonsei Univ, Severance Inst Vasc & Metab Res, Gangnam Severance Hosp, Dept Neurol,Coll Med, Seoul 06273, South Korea; [Lee, Hye Sun] Yonsei Univ, Dept Res Affairs, Biostat Collaborat Unit, Coll Med, Seoul 06273, South Korea; [Shin, Dong Hoon] Gachon Univ, Dept Neurol, Gil Med Ctr, Incheon 21565, South Korea; [Choi, Hye-Yeon] Kyung Hee Univ, Kyung Hee Univ Hosp Gangdong, Sch Med, Dept Neurol, Seoul 05278, South Korea; [Baek, Jang-Hyun] Natl Med Ctr, Dept Neurol, Seoul 04564, South Korea; [Baek, Jang-Hyun] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Neurol, Sch Med, Seoul 03181, South Korea; [Kim, Gyu Sik; Seo, Kwon-Duk] Ilsan Hosp, Dept Neurol, Natl Hlth Insurance Serv, Ilsan 10444, South Korea; [Kim, Seo Hyun] Yonsei Univ, Dept Neurol, Wonju Coll Med, Wonju 26426, South Korea; [Song, Tae-Jin] Ewha Womans Univ, Seoul Hosp, Dept Neurol, Coll Med, Seoul 07804, South Korea; [Han, Sang Won; Park, Joong Hyun] Inje Univ, Sanggye Paik Hosp, Dept Neurol, Coll Med, Seoul 01757, South Korea; [Kim, Jinkwon] CHA Univ, Dept Neurol, CHA Bundang Med Ctr, Seongnam 13496, South Korea; [Jung, Yo Han] Changwon Fatima Hosp, Dept Neurol, Chang Won 51394, South Korea; [Cho, Han-Jin] Pusan Natl Univ, Dept Neurol, Sch Med, Busan 49241, South Korea; [Ahn, Seong Hwan] Chosun Univ, Dept Neurol, Sch Med, Gwangju 61453, South Korea; [Lee, Sung Ik; Seo, Kwon-Duk] Wonkwang Univ, Sanbon Hosp, Dept Neurol, Sch Med, Sanbon 15865, South Korea
- 등재 SCIE, SCOPUS
- OA유형 gold, Green Published
- 발행기관 MDPI
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175757
- 본문언어 영어
- Published As http://dx.doi.org/10.3390/jcm9030717
- PubMed https://pubmed.ncbi.nlm.nih.gov/32155841
초록/요약
We investigated whether there was an annual change in outcomes in patients who received the thrombolytic therapy or endovascular treatment (EVT) in Korea. This analysis was performed using data from a nationwide multicenter registry for exploring the selection criteria of patients who would benefit from reperfusion therapies in Korea. We compared the annual changes in the modified Rankin scale (mRS) at discharge and after 90 days and the achievement of successful recanalization from 2012 to 2017. We also investigated the determinants of favorable functional outcomes. Among 1230 included patients, the improvement of functional outcome at discharge after reperfusion therapy was noted as the calendar year increased (p < 0.001). The proportion of patients who were discharged to home significantly increased (from 45.6% in 2012 to 58.5% in 2017) (p < 0.001). The successful recanalization rate increased over time from 78.6% in 2012 to 85.1% in 2017 (p = 0.006). Time from door to initiation of reperfusion therapy decreased over the years (p < 0.05). These secular trends of improvements were also observed in 1203 patients with available mRS data at 90 days (p < 0.05). Functional outcome was associated with the calendar year, age, initial stroke severity, diabetes, preadmission disability, intervals from door to reperfusion therapy, and achievement of successful recanalization. This study demonstrated the secular trends of improvement in functional outcome and successful recanalization rate in patients who received reperfusion therapy in Korea.
more