Kaiz S Asif, Arun Mitra, Santiago Ortega-Gutierrez, Nabeel Herial, Shashvat Desai, Ashutosh Jadhav, Fawaz Al-Mufti, Adrija Roy, Romil Singh, Grant Brown, Amrou Sarraj, Arun Jose, Anand Alurkar, A P Karapurkar, Arvind Sharma, Vipul Gupta, Gaurav Goel, Dheeraj Khurana, Biplab Das, Jayanta Roy, Deep Das, Rahul Kumar, Gigy Kuruttukulam, Pradeep Kumar Vg, Mv Padma Srivastava, Jeyaraj Pandian, Vikram Huded, Dileep Yavagal, Biju Soman, P N Sylaja
{"title":"印度急性缺血性卒中再灌注治疗的地理空间分析：对中心分布和可及性的评估。","authors":"Kaiz S Asif, Arun Mitra, Santiago Ortega-Gutierrez, Nabeel Herial, Shashvat Desai, Ashutosh Jadhav, Fawaz Al-Mufti, Adrija Roy, Romil Singh, Grant Brown, Amrou Sarraj, Arun Jose, Anand Alurkar, A P Karapurkar, Arvind Sharma, Vipul Gupta, Gaurav Goel, Dheeraj Khurana, Biplab Das, Jayanta Roy, Deep Das, Rahul Kumar, Gigy Kuruttukulam, Pradeep Kumar Vg, Mv Padma Srivastava, Jeyaraj Pandian, Vikram Huded, Dileep Yavagal, Biju Soman, P N Sylaja","doi":"10.1177/17474930241312598","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>We evaluated the spatial distribution and geographic accessibility of stroke centers in India.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14442,"journal":{"name":"International Journal of Stroke","volume":" ","pages":"17474930241312598"},"PeriodicalIF":6.3000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Geo-spatial analysis of acute ischemic stroke reperfusion treatment in India: An assessment of distribution and access to centers.\",\"authors\":\"Kaiz S Asif, Arun Mitra, Santiago Ortega-Gutierrez, Nabeel Herial, Shashvat Desai, Ashutosh Jadhav, Fawaz Al-Mufti, Adrija Roy, Romil Singh, Grant Brown, Amrou Sarraj, Arun Jose, Anand Alurkar, A P Karapurkar, Arvind Sharma, Vipul Gupta, Gaurav Goel, Dheeraj Khurana, Biplab Das, Jayanta Roy, Deep Das, Rahul Kumar, Gigy Kuruttukulam, Pradeep Kumar Vg, Mv Padma Srivastava, Jeyaraj Pandian, Vikram Huded, Dileep Yavagal, Biju Soman, P N Sylaja\",\"doi\":\"10.1177/17474930241312598\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>We evaluated the spatial distribution and geographic accessibility of stroke centers in India.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":14442,\"journal\":{\"name\":\"International Journal of Stroke\",\"volume\":\" \",\"pages\":\"17474930241312598\"},\"PeriodicalIF\":6.3000,\"publicationDate\":\"2025-01-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17474930241312598\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17474930241312598","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：脑卒中是全球死亡和残疾的主要原因，在低收入和中等收入国家造成的负担高得不成比例。获得静脉溶栓（IVT）和血管内治疗（EVT）仍然非常有限。目的：我们评估了印度中风中心的空间分布和地理可达性。方法：分别于2021年3月从取栓装置和制药行业供应商处收集具有静脉溶栓能力（IVT-C）和血管内治疗能力（EVT-C）卒中中心的数据。对数据进行整理和地理编码，以比较和计算区域统计数据和使用描述性统计的州/联邦领土（UT）摘要。人口中心的数据来自印度调查网站。为了估计驾驶时间，我们使用谷歌距离矩阵API来找到每个人口中心与其最近的中风设施之间的驾驶距离。随后，根据2020年的人口预测，并在各州之间进行比较，以每个时间间隔访问中风中心的人口比例来估计人口覆盖率。结果：共有566个IVT-C卒中中心分布在26个州和ut，其中361个（63%）是EVT-C。10个ut缺乏中风中心。IVT-C和EVT-C的平均卒中中心数（SCPM）分别为0.41和0.26。离最近的IVT-C中心和EVT-C中心的中位距离分别为115 km （IQR 66-175）和131 km （IQR 79-198）。分别有26.3%和20.6%的印度人口可在一小时内到达静脉血栓栓塞检查中心和静脉血栓栓塞检查中心。结论：印度卒中护理可及性较差，地区差异严重，SCPM人数少，驾驶时间长，黄金时间内可获得护理的人口较少。迫切需要在印度现有服务差的地区建立具有IVT和evt能力的卒中中心，以增加卒中患者的可及性并改善其预后。
Geo-spatial analysis of acute ischemic stroke reperfusion treatment in India: An assessment of distribution and access to centers.
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.
期刊介绍：
The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
