Non-English-speaking patients are less likely to arrive by ambulance when experiencing stroke symptoms, and also less likely to receive a mechanical thrombectomy procedure, according to research released at the 2024 Society of NeuroInterventional Surgery (SNIS) annual meeting (22–26 July, Colorado Springs, USA).
In the study—titled “English language proficiency as a predictor of mechanical thrombectomy access and outcomes”—researchers examined records for all patients who were treated for acute ischaemic stroke at one large comprehensive stroke centre (CSC) in the USA offering a full spectrum of neuroendovascular care.
Researchers sorted 1,162 patients into two groups: those whose preferred language was English (n=1,016) and those with a different preferred language (n=146). The study team then reviewed how the patients were treated for stroke, and found that English speakers were 1.47 times more likely to arrive at the hospital via ambulance compared to non-English speakers.
As noted in an SNIS press release, using this kind of emergency medical service (EMS) shortens the time to the hospital and streamlines care—and those who do not arrive via EMS are at risk of delayed care and potentially worse outcomes after stroke.
In the study, English speakers were also 1.57 times more likely to receive thrombectomy than non-English speakers, as well as being 1.73 times more likely to be discharged home. English speakers and non-English speakers were equally likely to receive care for stroke, and all patients who received thrombectomy were treated similarly quickly. And, although non-English speakers had slightly better recovery scores 24 hours after stroke, all patients with acute ischaemic stroke had similar recovery scores and similar rates of short- and long-term disability from stroke.
“The language you speak should not dictate access to rapid and definitive care for stroke—or any other medical emergency,” said Carl Porto (Warren Alpert Medical School of Brown University, Providence, USA), the primary author of this study. “It is important that we examine our practices and prioritise multilingual resources that may improve pre-stroke knowledge, and prevent delays in receiving care.”
