| アイテムタイプ |
学術雑誌論文 / Journal Article(1) |
| 公開日 |
2025-08-27 |
| タイトル |
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タイトル |
Community-Level Compact City Design, Health Care Provision, and Outcomes of Patients With Stroke |
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言語 |
en |
| 言語 |
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言語 |
eng |
| キーワード |
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言語 |
en |
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キーワード |
city design |
| キーワード |
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言語 |
en |
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キーワード |
city environment |
| キーワード |
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言語 |
en |
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キーワード |
compact city |
| キーワード |
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言語 |
en |
|
キーワード |
primary stroke center |
| キーワード |
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|
言語 |
en |
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キーワード |
stroke |
| キーワード |
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言語 |
en |
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キーワード |
urban |
| キーワード |
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言語 |
en |
|
キーワード |
walkability |
| 資源タイプ |
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資源タイプ |
journal article |
| アクセス権 |
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アクセス権 |
open access |
| 著者 |
Imaoka, Yukihiro
Ren, Nice
Ogata, Soshiro
Watanabe, Shogo
板谷, 智也
WEKO
34993
e-Rad_Researcher
10765192
| ja |
板谷, 智也
宮崎大学
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| ja-Kana |
イタタニ, トモヤ
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| en |
Itatani, Tomoya
University of Miyazaki
|
Search repository
Kiyoshige, Eri
Imamura, Hirotoshi
Nishimura, Kunihiro
Kobashi, Syoji
Kaku, Yasuyuki
Arimura, Koichi
Fukuda, Hitoshi
Ihara, Masafumi
Ohta, Tsuyoshi
Matsumaru, Yuji
Sakai, Nobuyuki
Kitazono, Takanari
Fujimoto, Shigeru
Ogasawara, Kuniaki
Yoshimoto, Koji
Mukasa, Akitake
Iihara, Koji
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| 抄録 |
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内容記述タイプ |
Abstract |
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内容記述 |
Background
The optimal scale of urbanization for stroke health care provision and the potential impact of compact city design on stroke outcomes remain unclear. We investigated the impact of zip code area‐level compact city design using the walkability index (WI) and its mediators on stroke outcomes.
Methods
This nationwide retrospective study used data from patients with stroke from the J‐ASPECT study (2017–2022). WI was calculated as the average of 3 Z‐scored city design elements (population density, road connectivity, and variation in walkable facilities) from 113 1156 zip code areas in Japan. The association between WI and in‐hospital mortality, functional independence at discharge, and medical costs was assessed using multivariable mixed‐effects logistic regression model.
Results
Overall, 555 296 patients (median age, 75 [interquartile range, 66–83] years; female, 42.5%) from 818 hospitals were included. Higher WI was significantly associated with decreased in‐hospital mortality (odds ratio [OR], 0.94 [95% CI, 0.92–0.96]) and increased functional independence (OR, 1.03 [95% CI, 1.02–1.04]). The highest WI group was associated with decreased mortality, primarily mediated by management in intensive or stroke care units (proportion mediated, 0.46 [95% CI, 0.35–0.63]), and the highest WI group was associated with increased functional independence, mediated by short road distance to the hospital (proportion mediated, 0.30 [95% CI, 0.21–0.44]).
Conclusions
Zip code area‐level compact city design was associated with decreased in‐hospital mortality and increased functional independence. Compact city design at community level, even without large‐scale urbanization, may contribute to improving stroke care provision and outcomes in increasingly urbanized societies. |
|
言語 |
en |
| 書誌情報 |
en : Journal of the American Heart Association
巻 14,
号 15,
p. e041293,
発行日 2025-07-23
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| 出版者 |
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出版者 |
American Heart Association |
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言語 |
en |
| ISSN |
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収録物識別子タイプ |
EISSN |
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収録物識別子 |
20479980 |
| DOI |
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関連タイプ |
isVersionOf |
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識別子タイプ |
DOI |
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関連識別子 |
https://doi.org/10.1161/JAHA.125.041293 |
| 権利 |
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権利情報 |
© 2025 The Author(s). |
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言語 |
en |
| 著者版フラグ |
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出版タイプ |
VoR |
Fulltext (2.2 MB)
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