J Stroke.  2015 Jan;17(1):38-53. 10.5853/jos.2015.17.1.38.

Case Characteristics, Hyperacute Treatment, and Outcome Information from the Clinical Research Center for Stroke-Fifth Division Registry in South Korea

Affiliations
  • 1Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea. braindoc@snu.ac.kr
  • 2Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Korea.
  • 3Department of Neurology, Eulji University Hospital, Daejeon, Korea.
  • 4Department of Neurology, Dong-A University Hospital, Busan, Korea.
  • 5Department of Neurology, Seoul Medical Center, Seoul, Korea.
  • 6Department of Neurology, Soonchunhyang University Hospital Seoul, Seoul, Korea.
  • 7Department of Neurology, Yeungnam University Medical Center, Daegu, Korea.
  • 8Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 9Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 10Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.
  • 11Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
  • 12Department of Neurology, Jeju National University Hospital, Jeju, Korea.
  • 13Department of Neurology, Ulsan University Hospital, Ulsan, Korea.
  • 14Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea.
  • 15Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • 16Department of Biostatistics, Korea University, Seoul, Korea.
  • 17Clinical Research Center, Asan Medical Center, Seoul, Korea.
  • 18Department of Neurology, Seoul National University Hospital, Seoul, Korea.

Abstract

Characteristics of stroke cases, acute stroke care, and outcomes after stroke differ according to geographical and cultural background. To provide epidemiological and clinical data on stroke care in South Korea, we analyzed a prospective multicenter clinical stroke registry, the Clinical Research Center for Stroke-Fifth Division (CRCS-5). Patients were 58% male with a mean age of 67.2+/-12.9 years and median National Institutes of Health Stroke Scale score of 3 [1-8] points. Over the 6 years of operation, temporal trends were documented including increasing utilization of recanalization treatment with shorter onset-to-arrival delay and decremental length of stay. Acute recanalization treatment was performed in 12.7% of cases with endovascular treatment utilized in 36%, but the proportion of endovascular recanalization varied across centers. Door-to-IV alteplase delay had a median of 45 [33-68] min. The rate of symptomatic hemorrhagic transformation (HT) was 7%, and that of any HT was 27% among recanalization-treated cases. Early neurological deterioration occurred in 15% of cases and were associated with longer length of stay and poorer 3-month outcomes. The proportion of mRS scores of 0-1 was 42% on discharge, 50% at 3 months, and 55% at 1 year after the index stroke. Recurrent stroke up to 1 year occurred in 4.5% of patients; the rate was higher among older individuals and those with neurologically severe deficits. The above findings will be compared with other Asian and US registry data in this article.

Keyword

Stroke registry; South Korea; Case profile; Hyperacute treatment; Thrombolysis; Outcome; Recurrent event

MeSH Terms

Asian Continental Ancestry Group
Humans
Korea
Length of Stay
Male
National Institutes of Health (U.S.)
Stroke
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Tissue Plasminogen Activator
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