Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Objectives: We aimed to investigate public perception of medical specialties in South Korea that diagnose and treat different sleep disorders. Methods: We conducted a web-based survey between January and February 2022, as part of the National Sleep Survey of South Korea 2022. A questionnaire was administered to a stratified, multistage sample of 4,000 random individuals aged 20–69 years from the general population. Participants were asked to select all sleep disorders they believed required treatment from a list. Subsequently, they were asked to identify the clinical department they would visit for each disorder. Results: Sleep apnea (83.4%) and snoring (82.4%) were widely perceived as sleep disorders requiring treatment, followed by insomnia (76.1%), sleepwalking (72.0%), narcolepsy (52.4%), bruxism (49.6%), rapid eye movement sleep behavior disorder (43.4%), excessive daytime sleepiness (33.4%), restless legs syndrome (30.1%), and sleep talking (18.5%). Regarding departments, otorhinolaryngology was the preferred specialty for snoring (79.7%) and sleep apnea (49.4%). More than half of the respondents (55.2%) indicated that they would consult psychiatry department, followed by neurology department (28.2%) for insomnia. Neurology department is preferred for restless legs syndrome, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, and narcolepsy. “Unsure” was a common response for more than 10% of the disorders, excluding snoring and insomnia, highlighting the gaps in public awareness regarding sleep disorders. Conclusions Public perceptions of the appropriate medical specialties for different sleep disorders vary and are often inconsistent with medical guidelines. Public education regarding the roles of different specialties in managing sleep disorders may improve care by guiding patients to the appropriate specialties.

Objectives: We aimed to investigate public perception of medical specialties in South Korea that diagnose and treat different sleep disorders. Methods: We conducted a web-based survey between January and February 2022, as part of the National Sleep Survey of South Korea 2022. A questionnaire was administered to a stratified, multistage sample of 4,000 random individuals aged 20–69 years from the general population. Participants were asked to select all sleep disorders they believed required treatment from a list. Subsequently, they were asked to identify the clinical department they would visit for each disorder. Results: Sleep apnea (83.4%) and snoring (82.4%) were widely perceived as sleep disorders requiring treatment, followed by insomnia (76.1%), sleepwalking (72.0%), narcolepsy (52.4%), bruxism (49.6%), rapid eye movement sleep behavior disorder (43.4%), excessive daytime sleepiness (33.4%), restless legs syndrome (30.1%), and sleep talking (18.5%). Regarding departments, otorhinolaryngology was the preferred specialty for snoring (79.7%) and sleep apnea (49.4%). More than half of the respondents (55.2%) indicated that they would consult psychiatry department, followed by neurology department (28.2%) for insomnia. Neurology department is preferred for restless legs syndrome, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, and narcolepsy. “Unsure” was a common response for more than 10% of the disorders, excluding snoring and insomnia, highlighting the gaps in public awareness regarding sleep disorders. Conclusions Public perceptions of the appropriate medical specialties for different sleep disorders vary and are often inconsistent with medical guidelines. Public education regarding the roles of different specialties in managing sleep disorders may improve care by guiding patients to the appropriate specialties.

Objectives: We aimed to investigate public perception of medical specialties in South Korea that diagnose and treat different sleep disorders. Methods: We conducted a web-based survey between January and February 2022, as part of the National Sleep Survey of South Korea 2022. A questionnaire was administered to a stratified, multistage sample of 4,000 random individuals aged 20–69 years from the general population. Participants were asked to select all sleep disorders they believed required treatment from a list. Subsequently, they were asked to identify the clinical department they would visit for each disorder. Results: Sleep apnea (83.4%) and snoring (82.4%) were widely perceived as sleep disorders requiring treatment, followed by insomnia (76.1%), sleepwalking (72.0%), narcolepsy (52.4%), bruxism (49.6%), rapid eye movement sleep behavior disorder (43.4%), excessive daytime sleepiness (33.4%), restless legs syndrome (30.1%), and sleep talking (18.5%). Regarding departments, otorhinolaryngology was the preferred specialty for snoring (79.7%) and sleep apnea (49.4%). More than half of the respondents (55.2%) indicated that they would consult psychiatry department, followed by neurology department (28.2%) for insomnia. Neurology department is preferred for restless legs syndrome, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, and narcolepsy. “Unsure” was a common response for more than 10% of the disorders, excluding snoring and insomnia, highlighting the gaps in public awareness regarding sleep disorders. Conclusions Public perceptions of the appropriate medical specialties for different sleep disorders vary and are often inconsistent with medical guidelines. Public education regarding the roles of different specialties in managing sleep disorders may improve care by guiding patients to the appropriate specialties.