Do Elderly Patients Call 911 When Presented with Clinical Scenarios Suggestive of Acute Stroke? A Cross-Sectional Study

Abstract

Background and Purpose: Among patients with acute stroke symptoms, delay in hospital admission is the main obstacle for the use of thrombolytic therapy and other interventions associated with decreased mortality and disability. The primary aim of this study was to assess whether an elderly clinical population correctly endorsed the response to call for emergency services when presented with signs and symptoms of stroke using a standardized questionnaire. Methods: We performed a cross-sectional study among elderly out-patients (≥60 years) in Buenos Aires, Argentina randomly recruited from a government funded health clinic. The correct endorsement of intention to call 911 was assessed with the Stroke Action Test and the cut-off point was set at ≥75%. Knowledge of stroke and clinical and socio-demographic indicators were also collected and evaluated as predictors of correct endorsement using logistic regression. Results: Among 367 elderly adults, 14% correctly endorsed intention to call 911. Presented with the most typical signs and symptoms, only 65% reported that they would call an ambulance. Amaurosis Fugax was the symptom for which was called the least (15%). On average, the correct response was chosen only 37% of the time. Compared to lower levels of education, higher levels were associated to correctly endorsed intention to call 911 (secondary School adjusted OR 3.53, 95% CI 1.59-7.86 and Tertiary/University adjusted OR 3.04, 95% CI 1.12-8.21). Conclusions: These results suggest the need to provide interventions that are specifically designed to increase awareness of potential stroke signs and symptoms and appropriate subsequent clinical actions.

“Invisible” visual impairments. A qualitative study of stroke survivors` experience of vision symptoms, health services and impact of visual impairments

“…This is similar to experiences described by stroke survivors in the UK [19]. Visual symptoms have been reported as the least known symptom of acute stroke [45,46]. Time from symptom to hospital treatment is crucial for stroke outcomes [47].…”

Knowledge of Stroke Risk Factors and Warning Signs in Patients with Recurrent Stroke or Recurrent Transient Ischaemic Attack in Thailand

“…Delayed arrival may be due to a lack of patient and public awareness of stroke symptoms, a decision to take a wait-and-see attitude, and a lack of proper immediate action [ 6 , 7 ]. More knowledge of stroke risk factors and stroke warning signs amongst patients is associated with an increased probability of correctly calling emergency services [ 8 ].…”

Differences in the awareness of stroke symptoms and emergency response by occupation in the Korean general population

“…Many stroke patients are still unable to arrive at the hospital within the golden time due to lack of knowledge on SWS [14]. Stroke awareness had a significant impact on early arrival at the hospital [26–28], although some studies have found that previous stroke knowledge in patients was not associated with decision delay or EMS use [25,29]. Therefore, it should be emphasized to the general public not only to quickly recognize SWS by patients/bystanders, but also to contact the EMS immediately when stroke symptoms develop.…”