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J Korean Soc Emerg Med > Volume 29(1); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(1): 85-92.
노인 급성 뇌경색 환자의 거주 형태에 따른 내원 시간 지연 요인
김윤권1, 곽명관1, 표창해1, 박상현1, 박근홍1, 김한범1, 신승열1, 최한조2, 함은미3
1서울의료원 응급의학과
2서남병원 응급의학과
3서울대학교병원 응급의학과
Analysis of Delayed Arrival Time According to the Residences Type of Elderly Acute Ischemic Stroke Patients
Yunkwon Kim1, Myoung Kwan Kwak1, Changhae Pyo1, Sanghyun Park1, Keunhong Park1, Hahnbom Kim1, Seoungyul Shin1, Hanzo Choi2, Eunmi Ham3
1Department of Emergency Medicine, Seoul Medical Center, Seoul, Korea
2Department of Emergency Medicine, Seonam Hospital, Seoul, Korea
3Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
Correspondence  Myoung Kwan Kwak ,Tel: 02-2276-7424, Fax: 02-2276-7418, Email: emdrkwak@gmail.com,
Received: September 11, 2017; Revised: September 13, 2017   Accepted: October 30, 2017.  Published online: February 28, 2018.
We made a clinical comparison of elderly patients from home and residential aged care facilities (RACFs) who visited the emergency department and were hospitalized with acute ischemic stroke. In addition, we investigated the factors associated with prehospital delay in acute ischemic stroke.
A retrospective study was conducted in a public hospital between January 2013 and December 2016. Information regarding the patients was registered including gender, age, comorbidities, symptoms at onset, use of emergency medical services, National Institute of Health Stroke Scale (NIHSS) at the emergency department, symptom-to-door time, etc. Characteristics of the patients were analyzed and logistic regression analysis was conducted to identify factors associated with symptom-to-door time.
A total of 402 patients were enrolled during the study period. Overall, 339 elderly patients visited from home and 63 patients from RACFs, and patients from home were divided into two groups, living with family (n=274) and living alone (n=65). Patients from RACFs were older (p<0.001) and had higher NIHSS (p=0.007) than patients from home, but there were no significant relationships between symptom-to-door time and age (p=0.525), NIHSS (p=0.428). There was no difference in symptom-to-door time between patients living with family and patients from RACFs, but patients living alone had delayed symptom-to-door time (p<0.001).
Elderly patients living alone were among the three groups that had the most delayed symptom-to-door time. Therefore, it is necessary to expand and supplement support for elderly patients living alone, as well as to improve education regarding acute ischemic stroke.
Key words: Housing for the elderly, Nursing homes, Transportation of patients, Cerebral infarction
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