Use of US emergency services for stroke differs by race and sex

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During a stroke, slightly more than half of patients use emergency medical services to get to the hospital, with white women the most likely, and Hispanic men the least likely to use emergency transport, according to new research in Journal of the American Heart Association.

Between October 2011 and March 2014, researchers analysed medical records from nearly 400,000 stroke patients admitted to more than 1,600 hospitals participating in the American Heart Association/American Stroke Association’s “Get With The Guidelines-Stroke”, a quality initiative to improve stroke treatment. Fifty per cent of stroke patients were women, 69% were white, 19% were black, 8% were Hispanic and 3% were Asian. Average age was 71, and most had the most common type of stroke which is caused by a blocked blood vessel.

 

Researchers found:

  • Women were overall more likely than men to use emergency services in the event of a stroke, with 62% of white women being transported by emergency services.
  • About 58% of black women and men used emergency services.
  • About 57% of Asian women and white men used emergency services.
  • About 55.5% of Hispanic women and Asian men used emergency services.
  • The group least likely to use emergency services was Hispanic men, at a little more than 52%.

“These findings are critically important because a significant predictor of stroke-related disability is the time interval between symptom onset and medical treatment,” said Heidi Mochari-Greenberger, lead author of the study and an associate research scientist at Columbia University Medical Center in New York, USA. “The use of emergency medical service transport is associated with shorter hospital arrival times.”

Fast treatment is critical during a stroke to restore blood flow to the brain and prevent tissue damage, and limit disability. Despite this, many people experiencing stroke symptoms do not receive timely treatment. Evidence shows that black people are more likely to die from a stroke than white people and that blacks and other minorities have more disability after a stroke than non-Hispanic whites. Since the reasons for these differences are unclear, the researchers sought to determine whether they might be related to emergency services use.

In other findings that confirm previous research, the researchers found that patients with well-recognised stroke symptoms, such as weakness, speech difficulty, or altered consciousness, were much more likely to use emergency medical services than people with less well-known symptoms.

“This information highlights a need for healthcare providers to educate patients and their families about stroke warning signs and taking action to call 9-1-1,” Mochari-Greenberger said. “Calling 9-1-1 at the time of stroke onset not only may increase the likelihood of one’s own survival, but those who are educated may also be in a position to save a life if they observe stroke symptoms in someone else and call emergency medical services immediately.”

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