Factors Associated with the Hospital Arrival Time in Patients with Ischemic Stroke in Korea

Background: Stroke is a leading cause of death and disability among the Korean population. Ischemic stroke patients tend to delay arrival at the hospital and often miss the "golden" 3-hour window, which is optimal for tissue plasminogen activator treatment. Objective: The purposes of this study were to compare demographic, clinical/behavioral, and sociocultural characteristics of ischemic stroke patients who reside in urban and rural areas of Korea and to identify factors contributing to the time taken from symptom onset to hospital arrival. Methods: A cross-sectional, descriptive study was conducted using a structured survey in a convenience sample of 229 ischemic stroke patients in Korea. Results: Individuals who resided in rural areas were more likely to be female, older, less educated; had lower incomes; contacted adult children at the onset of stroke; and took a longer time to be transported to a hospital than did those who resided in urban areas (P <.05). Patients who visited an emergency room, transferred via an ambulance, contacted emergency medical services, perceived symptoms as serious, had a family history of stroke, or experienced hemiparesis as the primary stroke symptom arrived at the hospital relatively sooner, whereas patients who experienced unclear symptoms took relatively more time to arrive at the hospital following symptom onset (P <.05). Conclusions: Nationwide efforts are needed to promote public awareness of stroke and to develop strategies to reduce prehospital delay time for ischemic stroke patients, particularly those who reside in rural areas in Korea.