National Center for Geographic Information and Analysis and Department of Geography, University at Buffalo - The State University of New York, Buffalo, New York, USA.
Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
J Neurointerv Surg. 2022 Jan;14(1). doi: 10.1136/neurintsurg-2020-016942. Epub 2021 Feb 16.
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.
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.
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.
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.
本横断面研究旨在确定美国有多少人口可在 60 分钟内到达认可的或州指定的血管内治疗能力的卒中中心（ECC）和无血管内治疗能力的卒中中心（NECC），以及有多少 30 分钟车程内有 ECC 的 NECC。
确定卒中中心，并将其广泛归类为 ECC 或 NECC。对卒中中心进行地理映射。将人群分为普查区，并计算其质心。从质心到最近的 ECC 和 NECC 的最快空中和地面旅行时间估计。
总体而言，49.6%的美国居民可在 60 分钟内到达 ECC。大约 37.7%（11300 万人）缺乏 60 分钟地面或空中到达 ECC 的机会。大约 84.4%的人可在 60 分钟内到达 NECC。仅地面交通可达 77.9%。大约 738 个 NECC（45.4%）在 30 分钟车程内有 ECC。
近三分之一的美国人口缺乏 60 分钟的血管内卒中治疗机会，但这种情况差异很大。应根据现有设施的位置和接近程度，为每个州量身定制交通模型和新中心规划。
