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

作者：Kaiz Asif, Kaiz S Asif, Arun Mitra, Arun Mitra, Santiago Ortega-Gutierrez, Nabeel Herial, Shashvat M. Desai, Ashutosh P. Jadhav, Fawaz Al‐Mufti, Adrija Roy, Romil Singh, Grant Brown, Amrou Sarraj, Arun Jose, Anand Alurkar, AP Karapurkar, Arvind Sharma, Vipul Gupta, Gaurav Goel, Dheeraj Khurana, Deep Das, Jayanta Roy, Deep Das, Vinod Kumar, Gigy Kuruttukulam, Pradeep Kumar VG, MV Padma Srivastava, Jeyaraj Pandian, Vikram Huded, Dileep R. Yavagal, Biju Soman, PN Sylaja, PN Sylaja · 发表于：International Journal of Stroke · 年份：2024 · DOI：10.1177/17474930241312598 · 被引用次数：7 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Cardiac Arrest and Resuscitation

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) ...