Geo-spatial analysis of acute ischemic stroke reperfusion treatment in India: An assessment of distribution and access to centers

被引：0

作者：

Asif, Kaiz S. ^{[1
]}

Mitra, Arun ^{[2
,3
]}

Ortega-Gutierrez, Santiago ^{[4
]}

Herial, Nabeel ^{[5
]}

Desai, Shashvat ^{[6
]}

Jadhav, Ashutosh ^{[7
]}

Al-Mufti, Fawaz ^{[8
]}

Roy, Adrija ^{[9
]}

Singh, Romil ^{[10
]}

Brown, Grant ^{[11
]}

Sarraj, Amrou ^{[12
]}

Jose, Arun ^{[13
]}

Alurkar, Anand ^{[14
]}

Karapurkar, A. P.

Sharma, Arvind ^{[15
]}

Gupta, Vipul ^{[16
]}

Goel, Gaurav ^{[17
]}

Khurana, Dheeraj ^{[18
]}

Das, Biplab ^{[19
]}

Roy, Jayanta ^{[20
]}

Das, Deep ^{[21
]}

Kumar, Rahul ^{[22
]}

Kuruttukulam, Gigy ^{[23
]}

Kumar, V. G. Pradeep

Srivastava, M. V. Padma

Pandian, Jeyaraj ^{[24
]}

Huded, Vikram ^{[25
]}

Yavagal, Dileep ^{[26
]}

Soman, Biju ^{[13
]}

Sylaja, P. N. ^{[3
]}

机构：

[1] Univ Illinois, Stroke & Neuroendovasc Surg, Ascens Hlth, Chicago, IL USA

[2] All India Inst Med Sci, Hyderabad, India

[3] Sree Chitra Tirunal Inst Med Sci & Technol, Thiruvananthapuram, India

[4] Univ Iowa Hosp & Clin, Dept Neurol Neurosurg & Radiol, Iowa City, IA USA

[5] Jefferson Einstein Montgomery Hosp, Dept Neurosurg, Stroke & Neuro Intervent Surg, Philadelphia, PA USA

[6] Honor Hlth Neurovasc Lab, Scottsdale, AZ USA

[7] Barrow Neurol Inst, Dept Neurol, Phoenix, AZ USA

[8] Westchester Med Ctr, Valhalla, NY USA

[9] Apollo Inst Med Sci & Res, Hyderabad, India

[10] Allegheny Gen Hosp, Pittsburgh, PA USA

[11] Univ Iowa, Dept Biostat, N314 CPHB, Iowa City, IA 52246 USA

[12] Univ Hosp Cleveland Med Ctr, Univ Hosp Neurol Inst, Cleveland, OH USA

[13] Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram, India

[14] KEM Hosp, Dept Neurovasc Intervent, Pune, India

[15] Zydus Hosp, Dept Neurol, Ahmadabad, India

[16] Artemis Hosp, Dept Neuroanaesthesia, Artemis Agrim Inst Neurosci, Gurugram, Haryana, India

[17] Medanta Hosp, Gurgaon, India

[18] Postgrad Inst Med Educ & Res, Dept Neurol, Chandigarh, India

[19] Yashoda Hosp, Intervent Neurol, Hyderabad, Telangana, India

[20] Inst Neurosci, Kolkata, India

[21] CK Birla Hosp, Woodlands Multispecial Hosp, Kolkata, India

[22] GS Neurosci Clin & Res Ctr, Patna, India

[23] Rajagiri Hosp, Kochi, India

[24] Christian Med Coll & Hosp, Ludhiana, India

[25] NH, Bangalore, NH, India

[26] Univ Miami, Jackson Mem Hosp, Miami, FL USA

来源：

INTERNATIONAL JOURNAL OF STROKE | 2025年

关键词：

stroke; thrombectomy; geomapping; healthcare; HEALTH-CARE; GLOBAL BURDEN; RISK-FACTORS; POPULATION; THROMBECTOMY; CHALLENGES; SYSTEMS; IMPACT; UNIT;

D O I：

10.1177/17474930241312598

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Stroke is a leading cause of global mortality and disability, with a disproportionately high burden in low- and middle-income countries. Access to intravenous thrombolysis (IVT) and endovascular treatment (EVT) remains extremely limited.Aims: We evaluated the spatial distribution and geographic accessibility of stroke centers in India.Methods: Data on IVT capable (IVT-C) and EVT capable (EVT-C) stroke centers were collected in March 2021 from thrombectomy devices and pharmaceutical industry providers, respectively. Data were collated and geocoded to compare and calculate zonal statistics and state/union territory (UT) summaries using descriptive statistics. Data on population centers were obtained from the Survey of India website. For estimating driving times, we used the Google Distance Matrix API to find the driving distance between each population center and its nearest stroke facility. Subsequently, population coverages were estimated as a proportion of the population having access to stroke centers for each time interval and based on the population projection for the year 2020 and compared across states.Results: A total of 566 IVT-C stroke centers were spread across 26 states and UTs, of which 361 (63%) were EVT-C. Ten UTs lacked stroke centers. The average stroke centers per million (SCPM) population was 0.41 and 0.26 for IVT-C and EVT-C, respectively. Median distances to the nearest IVT-C and EVT-C centers were 115 km (interquartile range (IQR): 66-175) and 131 km (IQR: 79-198), respectively. Access within 1 h to an IVT-C and an EVT-C center was available to 26.3% and 20.6% of the Indian population, respectively.Conclusions: Access to stroke care in India is poor, with critical regional disparities as reflected by the low SCPM population, long driving times, and a small population with access within the golden hour. There is an urgent need to establish IVT-C and EVT-C stroke centers in the existing poorly served regions of India to increase access and improve outcomes for stroke patients.

引用

页数：13

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