脳梗塞急性期医療の実態 厚生省健康科学総合研究事業脳梗塞急性期医療の実態に関する研究

Abstract

To investigate present status of ischemic stroke patients in Japan, a nation-wide, hospital-based survey was performed during a period from April 1997 to March 1998. Questionnaires were sent by mail to 4, 957 institutes selected on the basis of hospital lists published by the Ministry of Health and Welfare and of active members of Japan Stroke Society, Japanese Society of Neurology, Japanese Society of Emergency Medicine, and members of rank-A Neurosurgical training hospital.2, 048 valid responses were obtained from 1, 787 institutes (Responses were sent from 2 or more departents of the same institute).Results are summarized as follows :1) Ischemic brain infarction was found to be over 70% of all strokes. 2) Less than 30% of patients visited hospital within 6 hours of onset. 3) 43.6% of the institutes replied that they used thrombolytic agents at least in one patient (Thrombolytic agents were used, by calculation, in 8.3% of all patients), but true thrombolytic therapy (sufficient dose for thrombolysis) were performed in less than 17% of the institutes. 4) Intraarterial thrombolysis was carried out in 26% of the institutes, which made 2.7% of the all patients, by rough calculation. 5) The drug most frequently used for acute ischemic stroke in Japan was ozagrel sodium. 6) Only 3% of the institutes were equipped with stroke (care) unit (SCU). In 73% of the institutes, stroke patients were treated in general wards. 7) A mean hospital stay exceeded 28 days in 75% of the institutes (41 days in average). 8) An estimated mortality during admission was about 9%.