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. 2022 May 3;11(9):e023214.
doi: 10.1161/JAHA.121.023214. Epub 2022 May 2.

Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Cindy W Yoon  1 , Hoonji Oh  2 , Juneyoung Lee  2 , Joung-Ho Rha  1 , Seong-Ill Woo  1 , Won Kyung Lee  1 , Han-Young Jung  1 , Byeolnim Ban  3 , Jihoon Kang  3 , Beom Joon Kim  3 , Won-Seok Kim  3 , Chang-Hwan Yoon  3 , Heeyoung Lee  3 , Seongheon Kim  4 , Sung Hun Kim  4 , Eun Kyoung Kang  4 , Ae-Young Her  4 , Jae-Kwan Cha  5 , Dae-Hyun Kim  5 , Moo-Hyun Kim  5 , Jang Hoon Lee  6 , Hun Sik Park  6 , Keonyeop Kim  6 , Rock Bum Kim  7 , Nack-Cheon Choi  7 , Jinyong Hwang  7 , Hyun-Woong Park  7 , Ki Soo Park  7 , SangHak Yi  8 , Jae Young Cho  8 , Nam-Ho Kim  8 , Kang-Ho Choi  9 , Yongcheol Kim  9 , Juhan Kim  9 , Jae-Young Han  9 , Jay Chol Choi  10 , Song-Yi Kim  10 , Joon-Hyouk Choi  10 , Jei Kim  11 , Sung Ju Jee  11 , Min Kyun Sohn  11 , Si Wan Choi  11 , Dong-Ick Shin  12 , Sang Yeub Lee  12 , Jang-Whan Bae  12 , Kunsei Lee  13 , Hee-Joon Bae  3
Affiliations

Comparisons of Prehospital Delay and Related Factors Between Acute Ischemic Stroke and Acute Myocardial Infarction

Cindy W Yoon et al. J Am Heart Assoc. .

Abstract

Background Prehospital delay is an important contributor to poor outcomes in both acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We aimed to compare the prehospital delay and related factors between AIS and AMI. Methods and Results We identified patients with AIS and AMI who were admitted to the 11 Korean Regional Cardiocerebrovascular Centers via the emergency room between July 2016 and December 2018. Delayed arrival was defined as a prehospital delay of >3 hours, and the generalized linear mixed-effects model was applied to explore the effects of potential predictors on delayed arrival. This study included 17 895 and 8322 patients with AIS and AMI, respectively. The median value of prehospital delay was 6.05 hours in AIS and 3.00 hours in AMI. The use of emergency medical services was the key determinant of delayed arrival in both groups. Previous history, 1-person household, weekday presentation, and interhospital transfer had higher odds of delayed arrival in both groups. Age and sex had no or minimal effects on delayed arrival in AIS; however, age and female sex were associated with higher odds of delayed arrival in AMI. More severe symptoms had lower odds of delayed arrival in AIS, whereas no significant effect was observed in AMI. Off-hour presentation had higher and prehospital awareness had lower odds of delayed arrival; however, the magnitude of their effects differed quantitatively between AIS and AMI. Conclusions The effects of some nonmodifiable and modifiable factors on prehospital delay differed between AIS and AMI. A differentiated strategy might be required to reduce prehospital delay.

Keywords: acute ischemic stroke; acute myocardial infarction; prehospital delay.

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Figures

Figure 1
Figure 1. Locations of the 11 regional cardiocerebrovascular centers (RCCVCs) in South Korea.
Figure 2
Figure 2. Prehospital delay in patients with acute ischemic stroke (AIS) and acute myocardial infarction (AMI).
See this image and copyright information in PMC

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