Eftekhar Behzad
Neurological Surgery, University of Sydney, Sydney, AUS.
Neurological Surgery, Macquarie University, Sydney, AUS.
Cureus. 2023 Aug 28;15(8):e44285. doi: 10.7759/cureus.44285. eCollection 2023 Aug.
Objective To provide an estimate of access times and distances to an endovascular clot retrieval (ECR) service provider for a typical stroke patient in the western part of Sydney and to compare it with the eastern and northern parts. Methods Incidences of stroke were simulated through a population-weighted randomized selection of addresses in the studied western, eastern, and northern areas of Sydney (100,000 times for each). The access times and distances were calculated from those addresses to the closest ECR hub for the eastern and northern parts and to all five ECR hubs, as well as the Nepean Public Hospital (NPH) for the western part. The access times and distance means were compared statistically using ANOVA. Results In the western areas, the estimated average access times and distances to different ECR hubs varied from 38.5 (+/- 15) to 45 (+/- 15) minutes and from 42 (+/- 15.9) to 46.8 (+/- 16) km in working hours and from 45 (+/- 15) to 64 (+/- 15) minutes and 46.8 (+/- 16) to 69.6 (+/- 16) km in after hours. However, the estimated average access times and distances to the local ECR hub were 12.25 (+/- 6) minutes and 9.1 (+/- 5.6) km for northern and 7.5 (+/- 4) minutes and 4.4 (+/- 2.5) km for the eastern areas. The differences between the estimated average access times and distances for a typical stroke patient to an ECR hub in the western areas in comparison with eastern or northern areas were statistically significant (p<0.0001). The average access times and distances in the western part to NPH were 17 (+/- 16) minutes and 15.6 (+/- 16.6) km. Conclusions The patients in the western part of Sydney had significantly longer access times to ECR hubs than those living in comparable areas of the eastern and northern parts. This study supports the Nepean Public Hospital supplying an ECR service to achieve travel times, and, therefore, treatment times for a typical stroke patient in the western parts, similar to patients in the eastern and northern parts of Sydney.
目的 评估悉尼西部典型中风患者前往血管内血栓清除（ECR）服务机构的就诊时间和距离，并与悉尼东部和北部进行比较。方法 通过对悉尼西部、东部和北部研究区域的地址进行人口加权随机选择来模拟中风发病率（每个区域100,000次）。计算从这些地址到东部和北部最近的ECR中心、西部所有五个ECR中心以及内佩恩公立医院（NPH）的就诊时间和距离。使用方差分析对就诊时间和距离均值进行统计学比较。结果 在西部地区，工作日前往不同ECR中心的估计平均就诊时间和距离分别为38.5（±15）至45（±15）分钟和42（±15.9）至46.8（±16）千米，非工作时间分别为45（±15）至64（±15）分钟和46.8（±16）至69.6（±16）千米。然而，北部地区前往当地ECR中心的估计平均就诊时间和距离分别为12.25（±6）分钟和9.1（±5.6）千米，东部地区为7.5（±4）分钟和4.4（±2.5）千米。与东部或北部地区相比，悉尼西部典型中风患者前往ECR中心的估计平均就诊时间和距离差异具有统计学意义（p<0.0001）。西部地区前往NPH的平均就诊时间和距离分别为17（±16）分钟和15.6（±16.6）千米。结论 悉尼西部地区的患者前往ECR中心的就诊时间明显长于悉尼东部和北部类似地区的患者。本研究支持内佩恩公立医院提供ECR服务，以使悉尼西部地区典型中风患者的出行时间以及治疗时间与悉尼东部和北部地区患者相似。
