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EMS use for stroke varies by race, gender
In an analysis of a large stroke registry, 59% of patients were transferred to a hospital by emergency medical services, but use varied by race and gender.
Asian and Hispanic adults and black women were less likely to use emergency medical services (EMS) compared with white adults, researchers reported in the Journal of the American Heart Association.
Researchers analyzed data from the Get With the Guidelines–Stroke registry, including nearly 400,000 patients (mean age, 71 years) admitted to 1,613 U.S. centers for acute stroke between October 2011 and March 2014. The cohort was evenly distributed by gender, but varied by race/ethnicity (69% white; 19% black; 8% Hispanic; 3% Asian).
More than half of patients used EMS transportation during a stroke event, and 85.6% were diagnosed with ischemic stroke. According to the findings, women were more likely to use EMS compared with men. Moreover, white women were most likely to use EMS (62%) and Hispanic men were least likely to use EMS (52.2%).
Racial/ethnic disparities in EMS use were observed within the cohort. Overall, approximately 58% of patients who used EMS were black, 57% Asian and 55.5% Hispanic. Hispanic or Asian adults were 20% to 29% less likely to use EMS transport compared with white adults, and black women were less likely to use EMS transport compared with white women. Adjustment for stroke symptoms yielded similar outcomes.
Patients presenting with major stroke symptoms, such as weakness or paresis (67.3%), altered level of consciousness (22.3%) and aphasia (41.3%), also were more likely to use EMS transportation. Men and white adults were more likely to call for EMS transport based on their stroke symptoms compared with women and other races/ethnicities. EMS use was less common in patients with neurological symptoms, which were more prevalent in Asian and Hispanic adults and may partially explain lower EMS use in these populations, according to the researchers.
“This information highlights a need for health care providers to educate patients and their families about stroke warning signs and taking action to call 9-1-1,” Heidi Mochari-Greenberger, PhD, MPH, associate research scientist at Columbia University Medical Center, said in a press release. “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 [EMS] immediately.” – by Stephanie Viguers
Disclosure: Mochari-Greenberger reports no relevant financial disclosures.