Asians and Hispanics May Underutilize EMS Services For Stroke Symptoms

Heidi Mochari-Greenberger Ph.D., M.P.H Associate research scientist Columbia University Medical Center New York, N.YMedicalResearch.com Interview with:
Heidi Mochari-Greenberger Ph.D., M.P.H
Associate research scientist
Columbia University Medical Center
New York, N.Y

MedicalResearch: What is the background for this study?

Dr. Mochari-Greenberger: Differences in activation of emergency medical services (EMS) may contribute to race/ethnic and sex disparities in stroke outcomes. The purpose of this study was to determine whether EMS use varied by race/ethnicity or sex among a contemporary, diverse national sample of hospitalized acute stroke patients.

MedicalResearch: What are the main findings?

Dr. Mochari-Greenberger: Use of EMS transport among hospitalized stroke patients was less than 60% and varied by race/ethnicity and sex; EMS use was highest among white females and lowest among Hispanic males. Our analyses showed that Hispanic and Asian men and women were significantly less likely than their white counterparts to use EMS; black females were less likely than white females to use EMS, but black men had a similar rate to white men. These observed associations between race/ethnicity and sex with EMS use persisted after adjustment for stroke symptoms and other factors known to be associated with EMS use, indicating they were not driven solely by stroke symptom differences.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Mochari-Greenberger: This information highlights a need for clinicians to educate patients and their families about stroke warning signs and taking action to call 9-1-1. Calling EMS at the time of stroke onset not only may increase the likelihood of one’s own survival — 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.

This is critically important for patients and for the public, because a significant predictor of stroke-related disability is the time interval between symptom onset and medical treatment, and the use of EMS transport is associated with shorter hospital arrival times. Rapid stroke treatment is associated with better outcomes, and treatment delays may contribute to race/ethnic differences in stroke outcomes.

Continued efforts to educate patients, their families, and the public about stroke symptoms and EMS use through public health programs such as the American Heart Association F.A.S.T. campaign (Face drooping, Arm weakness, Speech difficulty, Time to call 9-1-1), as well as through education from healthcare providers, can help to raise awareness. 

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Mochari-Greenberger: Our study provided a snapshot of EMS use by race-ethnicity and sex in a current sample of hospitalized stroke patients in the United States. The reasons for race-ethnic and sex differences in EMS use are important subjects of future research. Continued research is needed to develop programs effective to increase stroke preparedness and action to call 9-1-1 among men and women from all race-ethnic backgrounds.

Citation:
Heidi Mochari-Greenberger et al. Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry. JAHA: Journal of the American Heart Association, August 2015 DOI: 10.1161/JAHA.115.002099

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