Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room

  • Sang Hyuk, Lee (Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Taek Min, Nam (Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Ji Hwan, Jang (Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Young Zoon, Kim (Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kyu Hong, Kim (Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kyeong Hwa, Ryu (Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Do-Hyung, Kim (Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Byung Soo, Kwan (Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Hyungon, Lee (Department of Neurosurgery, Dongnam Institute of Radiological & Medical Sciences) ;
  • Seung Hwan, Kim (Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2022.04.20
  • Accepted : 2022.08.16
  • Published : 2023.01.01
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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.

Keywords

References

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