ArticleJournal of the American Heart Association2021
Regional Disparity of Reperfusion Therapy for Acute Ischemic Stroke in Japan: A Retrospective Analysis of Nationwide Claims Data from 2010 to 2015.
Article in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Pooled it
- Nationwide trends in cardiac anesthesia requiring cardiopulmonary bypass and intraoperative transesophageal echocardiography use in Japan: a claims-based analysis, 2019-2023.Journal of anesthesia · 2026Article
- Geographic disparities in EVT access and stroke mortality under universal health coverage in South Korea.BMC health services research · 2026Article
- Regional disparities in shoulder surgery related to distribution of specialists: national database analysis.JSES international · 2025Article
- Varying Rates of Hospital Reperfusion Therapy for Stroke: Insights From Analysis of National Stroke Audit Data.Journal of stroke · 2025Article
- Association between procedure volume and 30-day mortality in stroke patients treated with EVT or IV rt-PA during the introduction period of EVT in Japan.Global health & medicine · 2025Article
- Variations in Methodological Approaches to Measuring Health Inequalities and Inequities: A Scoping Review of Acute Stroke Pathways.Healthcare (Basel, Switzerland) · 2025Review
- Regional Disparities in Hyperacute Treatment and Functional Outcomes after Acute Ischemic Stroke in Japan.Journal of atherosclerosis and thrombosis · 2024Article
- Inter-prefectural regional disparities in gastric cancer surgery: A Japanese nationwide population-based cohort study from 2014 to 2019.Annals of gastroenterological surgery · 2024Article
- Addressing disparities in the global epidemiology of stroke.Nature reviews. Neurology · 2024Review
- The Capacitated Maximal Covering Location Problem Improves Access to Stroke Treatment: A Cross-Sectional Simulation Study.Health services insights · 2024Article
- Optimal allocation of physicians improves accessibility and workload disparities in stroke care.International journal for equity in health · 2023Article
- The inter-prefectural regional disparity of healthcare resources and representative surgical procedures in orthopaedics and general surgery: a nationwide study in Japan during 2015-2019.BMC musculoskeletal disorders · 2023Article
- Registry Studies of Stroke in Japan.Journal of atherosclerosis and thrombosis · 2023Article
- Access to mechanical thrombectomy and ischemic stroke mortality in Japan: a spatial ecological study.Frontiers in neurology · 2023Article
- Spatial-temporal analysis of cerebral infarction mortality in Hokkaido, Japan: an ecological study using a conditional autoregressive model.International journal of health geographics · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background We aimed to determine whether a regional disparity exists in usage of reperfusion therapy (intravenous recombinant tissue plasminogen activator [IV rt-PA] and endovascular thrombectomy [EVT]) and post-reperfusion 30-day mortality in patients with acute ischemic stroke, and which regional factors are associated with their usage. Methods and Results We retrospectively investigated 69 948 patients (mean age±SD, 74.9±12.0 years; women, 41.4%) with acute ischemic stroke treated with reperfusion therapy between April 2010 and March 2016 in Japan using nationwide claims data. Regional disparity was evaluated using Gini coefficients for age- and sex-adjusted usage of reperfusion therapy and 30-day post-reperfusion in-hospital death ratio in 47 administrative regions. The association between regional factors and reperfusion therapy usage was evaluated with fixed-effects regression models. During the study period, Gini coefficients showed low inequality (0.11-0.15) for use of IV rt-PA monotherapy and IV rt-PA and/or EVT and extreme inequality (0.49) for EVT usage in 2010, which became moderate inequality (0.25) by 2015. The densities of stroke centers and endovascular specialists, as well as market concentration, were associated with increased usage of reperfusion therapy whereas the proportion of rural residents and delayed ambulance transport were negatively associated with usage. Inequality in the standardized death ratio after EVT was extreme (0.86) in 2010 but became moderate (0.29) by 2015; inequality was low to moderate (0.17-0.23) for IV rt-PA monotherapy and IV rt-PA and/or EVT. Conclusions Scrutinizing existing data sources revealed regional disparity in reperfusion therapy for acute ischemic stroke and its associated regional factors in Japan.
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