在美国绘制血管内卒中治疗的路径图及其对运输模型的影响

在美国绘制血管内卒中护理的路径图及其对运输模型的影响


摘要

背景：这项横断面研究的目的是确定60分钟地面或空中可到达经认可或国家指定的血管内卒中中心（ECC）和非血管内卒中中心（NECC）的美国人口百分比，以及30分钟车程内有ECC的NECC百分比。


方法：将脑卒中中心大致分为ECCs和NECCs。对中风中心进行地理测绘。将人口划分为普查区，并计算其质心。估计了从质心到最近的ECC和NECC的最快空中和地面旅行时间。


结果：总体而言，49.6%的美国居民有60分钟的地面访问ECCs。大约37.7%（1.13亿人）缺少60分钟的地面或空中ECCs通道。大约84.4%的人有60分钟的时间进入NECC。77.9%的人有地面通道。大约738名NECC（45.4%）在30分钟车程内发生ECC。


结论：近三分之一的美国人口缺乏60分钟的血管内卒中护理，但这是一个很大的变量。交通模式和额外中心的规划应根据现有设施的位置和邻近程度，针对每个州进行调整。J Neurointerv Surg

. 2021 Feb 16;neurintsurg-2020-016942.

 doi: 10.1136/neurintsurg-2020-016942. Online ahead of print.

Mapping access to endovascular stroke care in the USA and implications for transport models

Jared Aldstadt # 1, Muhammad Waqas # 2 3, Misa Yasumiishi 1, Maxim Mokin 4 5, Vincent M Tutino 2 6, Hamid H Rai 7, Felix Chin 7, Bennett R Levy 8, Ansaar T Rai 9, J Mocco 10, Kenneth V Snyder 3 11, Jason M Davies 3 12, Elad I Levy 2 3, Adnan H Siddiqui 13 3

Affiliations expand

• PMID: 33593798

•  

• DOI: 10.1136/neurintsurg-2020-016942

Abstract

Background: The purpose of this cross-sectional study was to determine the percentage of the US population with 60 min ground or air access to accredited or state-designated endovascular-capable stroke centers (ECCs) and non-endovascular capable stroke centers (NECCs) and the percentage of NECCs with an ECC within a 30 min drive.

Methods: Stroke centers were identified and classified broadly as ECCs or NECCs. Geographic mapping of stroke centers was performed. The population was divided into census blocks, and their centroids were calculated. Fastest air and ground travel times from centroid to nearest ECC and NECC were estimated.

Results: Overall, 49.6% of US residents had 60 min ground access to ECCs. Approximately 37.7% (113 million) lack 60 min ground or air access to ECCs. Approximately 84.4% have 60 min access to NECCs. Ground-only access was available to 77.9%. Approximately 738 NECCs (45.4%) had an ECC within a 30 min drive.

Conclusion: Nearly one-third of the US population lacks 60 min access to endovascular stroke care, but this is highly variable. Transport models and planning of additional centers should be tailored to each state depending on location and proximity of existing facilities.