Department of Neurology, General Hospital Amstetten, Amstetten, Austria.
Department of Neurology, Hospital St. John´s of God, Vienna, Austria.
PLoS One. 2019 Apr 10;14(4):e0214980. doi: 10.1371/journal.pone.0214980. eCollection 2019.
Differences in stroke risk factors and treatment variables between rural and urban regions in Austria were analyzed retrospectively as European data on this topic are scarce.
We performed statistical analysis using group comparisons and time series analysis of data of the Austrian Stroke Unit Registry between 2005 and 2016. 87411 patients were divided into three groups (rural, intermediate, urban) according to the degree of urbanisation classification of the European Commission/Eurostat.
Patients in the rural group were significantly younger, more often female, had a lower pre-stroke disability, and were more frequently transported by an emergency physician. Vascular risk factors were significantly higher in urban patients, leading to a higher rate of microangiopathic etiology. Onset-to-door (ODT) and Onset-to-treatment times were significantly higher in the rural group, but ODTs decreased over time. Door-to-needle times and time to first vascular imaging were significantly lower in the rural group. Intravenous thrombolysis and rehabilitation rates were lower in urban patients.
Contrary to previous literature predominantly from outside of Europe, vascular risk factors were higher in Austrian urban patients. Further, rural patients had higher intravenous thrombolysis and rehabilitation rates maybe because of lower pre-stroke disability. ODTs in rural patients were generally higher, but they decreased over time, which might be a consequence of better education of the public in noticing early stroke signs, better transportation and education of emergency medical personnel, better advance notification to the receiving hospital and implementation of Stroke Units in rural areas.
由于欧洲在该主题上的数据匮乏，本研究回顾性分析了奥地利农村和城市地区之间在中风风险因素和治疗变量方面的差异。
我们使用组间比较和 2005 年至 2016 年奥地利中风单元登记处的数据时间序列分析进行了统计分析。根据欧盟委员会/欧统局的城市化分类，将 87411 名患者分为三组（农村、中间、城市）。
农村组患者明显更年轻，女性更多，卒中前残疾程度更低，更多地由急诊医生转运。城市患者的血管风险因素显著更高，导致微血管病病因的发生率更高。农村组的发病至入院（ODT）和发病至治疗时间显著更长，但随着时间的推移 ODT 有所减少。农村组的门到针时间和首次血管成像时间明显更短。城市患者的静脉溶栓和康复率较低。
与主要来自欧洲以外的先前文献相反，奥地利城市患者的血管风险因素更高。此外，农村患者的静脉溶栓和康复率较高，可能是由于卒中前残疾程度较低。农村患者的 ODT 总体较高，但随着时间的推移有所减少，这可能是由于公众对早期卒中症状的认识、对急救医务人员的更好的转运和教育、对接收医院的更好的预先通知以及农村地区卒中单元的实施等方面的改善。
