Abstract
Introduction
Our objective was to determine whether acute ischemic stroke (AIS) patients' language
preference is associated with differences in time from symptom discovery to hospital
arrival, activation of emergency medical services, door-to-imaging time (DTI), and
door-to-needle (DTN) time.
Methods
We identified consecutive AIS patients presenting to a single urban, tertiary, academic
center between 01/2003–05/2014 for whom language preference was available. Data were
abstracted from the institution's Research Patient Data Registry and Get with the
Guidelines-Stroke Registry. Bivariate and regression models evaluated the relationship
between language preference and: 1) time from symptom onset to hospital arrival, 2)
use of EMS, 3) DTI, and 4) DTN time.
Results
Of 3190 AIS patients, 300 (9.4%) were non-English preferring (NEP). Comparing NEP
to English preferring (EP) patients in unadjusted or adjusted analyses, time from
symptom discovery to arrival and rate of EMS utilization were not significantly different
(overall median time 157 min, IQR 55–420; EMS utilization: 65% vs. 61.3% p = 0.21). There was also no significant differences in DTI or in likelihood of guideline-recommended
DTI ≤ 25 min (overall median 59 min, IQR 29–127; DTI ≤ 25 min 24.3% vs. 21.3% p = 0.29) or DTN time or in likelihood of guideline-recommended DTN ≤ 60 min (overall
median 53 min, IQR 36–73; DTN ≤ 60 min 62.5% vs. 58.2% p = 0.60).
Conclusion
Consistent with prior reports examining disparities in care, a systems-based approach
to acute stroke prevents differences in hospital-based metrics. Reassuringly, NEP
and EP patients also had similar speed of symptom recognition and EMS utilization.
Keywords
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Article Info
Publication History
Published online: November 02, 2020
Accepted:
October 27,
2020
Received in revised form:
October 26,
2020
Received:
September 7,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
