Abstract
Treatment of acute stroke with thrombolytic therapy has been limited because of the narrow treatment window. Distance from home to hospital may affect arrival time and likelihood of receiving thrombolytic therapy for acute stroke. The present study included stroke subjects seen at Barnes Jewish Hospital in 2006-2007, residing in St Louis City/County, who were at home at the time of the stroke (n = 416). A network distance was calculated by mapping the best route from each subject's home to the hospital on a street network grid. Patients were grouped by distance into quintiles, and the group living the closest (group A, first quintile) was compared with the remainder of the cohort (group B). Outcomes of interest were rate of arrival within 3 hours of stroke onset (timely arrival) and rate of thrombolytic administration. The relative rate (RR) of each outcome was calculated for group A versus group B. A multivariate model of thrombolytic administration was created correcting for potential confounders. There was no difference in timely arrival between groups. The rate of thrombolytic administration was 13/100 for group B and 23/100 for group A, for an RR 0.55 (95% confidence interval [CI], 0.31-0.097) for group B versus group A. I...Continue Reading
References
Oct 4, 1995·JAMA : the Journal of the American Medical Association·W HackeM H Mahagne
Dec 11, 1999·JAMA : the Journal of the American Medical Association·W M ClarkS Hamilton
Jan 4, 2001·Stroke; a Journal of Cerebral Circulation·C R LacyJ B Kostis
Apr 26, 2001·Neurology·P A BarberA M Buchan
Sep 6, 2001·Stroke; a Journal of Cerebral Circulation·S C JohnstonA N Brown
Aug 8, 2001·Neuroepidemiology·L B GoldsteinD P Wood
Oct 15, 2003·Archives of Internal Medicine·Lewis B MorgensternWenyaw Chan
Jun 30, 2005·Neurology·A I QureshiUNKNOWN Buffalo Metropolitan Area and Erie County Stroke Study Group
Jul 1, 2005·American Journal of Epidemiology·Donna Spiegelman, Ellen Hertzmark
Dec 21, 2006·American Journal of Preventive Medicine·Nancy K Hills, S Claiborne Johnston
Aug 29, 2007·Neurology·S SchwabUNKNOWN TEMPiS Group
Feb 20, 2008·International Journal of Health Geographics·Philippe ApparicioRichard Shearmur
Feb 23, 2008·Stroke; a Journal of Cerebral Circulation·John M ReidStephen J Phillips
Feb 26, 2008·Lancet Neurology·Stephen M DavisUNKNOWN EPITHET investigators
Sep 16, 2008·Lancet·Nils WahlgrenUNKNOWN SITS investigators
May 30, 2009·Stroke; a Journal of Cerebral Circulation·Gregory J Del ZoppoUNKNOWN American Heart Association Stroke Council
Citations
Aug 6, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Susumu KunisawaYuichi Imanaka
Apr 4, 2012·Spatial and Spatio-temporal Epidemiology·Martin A Healy, Jason A Gilliland
Apr 10, 2016·Implementation Science : IS·Christine L PaulChristopher R Levi
Oct 9, 2015·PloS One·Hiroki MatsuiHideo Yasunaga
Jul 20, 2019·Neurology·Jeremy AderKevin N Sheth
Mar 24, 2021·Journal of Korean Medical Science·Jay Chol ChoiAnthony S Kim