Perception of stroke symptoms and utilization of emergency medical services

Abstract

Lack of stroke awareness and slow activation of emergency medical services (EMS) are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75%) arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02). Nineteen patients (20%) were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001). Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

Stroke Knowledge in Spanish-Speaking Populations

“…[45-47] The latter association was not found in Argentina and Spain. [33,46] For example, in Spain, 76.2% of patients with recurrent stroke did not recognize new events after the first one. [46] Interestingly educational level was not related with correct stroke symptoms recognition in the same studies.…”

“…[46] Interestingly educational level was not related with correct stroke symptoms recognition in the same studies. [33,46]…”

“…However indirect findings suggest that misdiagnosis may interfere with initial stroke workup and hence thrombolysis in SSP. [6,33,45,51]…”

“…The principal cause was misdiagnosis, with a non-neurologist being the initial provider 95% of the time. [33]…”

Impact of a theory-informed and user-centered stroke information campaign on the public’s behaviors, attitudes, and knowledge when facing acute stroke: a controlled before-and-after study.

“…Knowledge concerning stroke symptoms is poor in the general population (1)(2)(3). Patients and relatives thus encounter di culties in symptom recognition, and response is often inappropriate.…”