ÀÌ»óÇõ(Lee Sang-Hyuk) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
³²ÅùÎ(Nam Taek-Min) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Neurosurgery
ÀåÁöȯ(Jang Ji-Hwan) - Sungkyunkwan University School of Medicine Department of Neurosurgery
±è¿µÁØ(Kim Young-Zoon) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Neurosurgery
±è±ÔÈ«(Kim Kyu-Hong) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Neurosurgery
±èµµÇü(Kim Do-Hyung) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
±è½Âȯ(Kim Seung-Hwan) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Neurosurgery
Abstract
Objective : With the recent increase in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the role of neurosurgeons in AIS treatment has become increasingly important. This study aimed to assess the outcomes of patients with AIS treated by neurosurgeons and neurologists in the emergency room (ER) of a tertiary hospital in South Korea.
Methods : From January 2020 to June 2021, 536 patients with AIS within 24 hours of symptom onset were admitted to our hospital via the ER. Based on the type of doctors who provided initial care for AIS in the ER, patients were divided into two groups : (a) neurosurgeon group (n=119, 22.2%) and (b) neurologist group (n=417, 77.8%).
Results : Intravenous tissue plasminogen activator (tPA) was administered in 82 (15.3%) of 536 patients (n=17 [14.3%] in the neurosurgeon group and n=65 [15.6%] in the neurologist group). The door-to-tPA time was not significantly different between both groups (median, 53 minutes; interquartile range [IQR], 45-58 vs. median, 54 minutes; IQR, 46-74; p=0.372). MT was performed in 69 patients (12.9%) (n=25, 36.2% in the neurosurgeon group and n=44, 63.8% in the neurologist group). The neurosurgeon group achieved a shorter door-to-puncture time than the neurologist group (median, 115 minutes; IQR, 107-151 vs. median, 162 minutes; IQR, 117-189; p=0.049). Good clinical outcomes (3-month modified Rankin Scale 0-2) did not differ significantly between the two groups (96/119 [80.7%] vs. 322/417 [77.2%], p=0.454).
Conclusion : The neurosurgeon group showed similar door-to-treatment time and clinical outcomes to the neurologist group in patients with AIS in the ER. This study suggests that neurosurgeons have comparable abilities to care for patients with AIS in the ER.
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Ischemic stroke , Neurosurgeons , Neurologists , Emergency , Treatment
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À¯È¿¼º°á°ú(Recomendation)
The neurosurgeon group showed similar door-to-treatment time and clinical outcomes to the neurologist group in patients with AIS in the ER.