Malek Angela M, Adams Robert J, Debenham Ellen, Boan Andrea D, Kazley Abby S, Hyacinth Hyacinth I, Voeks Jenifer H, Lackland Daniel T
Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina.
Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina.
J Stroke Cerebrovasc Dis. 2014 Oct;23(9):2362-71. doi: 10.1016/j.jstrokecerebrovasdis.2014.05.011. Epub 2014 Sep 10.
Response to stroke symptoms and the use of 911 can vary by race/ethnicity. The quickness with which a patient responds to such symptoms has implications for the outcome and treatment. We sought to examine a sample of patients receiving a Remote Evaluation of Acute isCHemic stroke (REACH) telestroke consult in South Carolina regarding their awareness and perception of stroke symptoms related to the use of 911 and to assess possible racial/ethnic disparities.
As of September 2013, 2325 REACH telestroke consults were conducted in 13 centers throughout South Carolina. Telephone surveys assessing use of 911 were administered from March 2012-January 2013 among 197 patients receiving REACH consults. Univariate and multivariate logistic regression was performed to assess factors associated with use of 911.
Most participants (73%) were Caucasian (27% were African-American) and male (54%). The mean age was 66 ± 14.3 years. Factors associated with use of 911 included National Institutes of Health Stroke Scale scores >4 (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.63-11.25), unknown insurance which includes self-pay or not charged (OR, 2.90; 95% CI, 1.15-7.28), and perception of stroke-like symptoms as an emergency (OR, 4.58; 95% CI, 1.65-12.67). African-Americans were significantly more likely than Caucasians to call 911 (62% vs. 43%, P = .02).
African-Americans used 911 at a significantly higher rate. Use of 911 may be related to access to transportation, lack of insurance, or proximity to the hospital although this information was not available. Interventions are needed to improve patient arrival times to telemedicine equipped emergency departments after stroke.
对中风症状的反应以及拨打911急救电话的情况可能因种族/族裔而异。患者对这些症状的反应速度会对治疗结果产生影响。我们试图对南卡罗来纳州接受急性缺血性中风远程评估（REACH）远程中风会诊的患者样本进行调查，了解他们对与拨打911相关的中风症状的认知和看法，并评估可能存在的种族/族裔差异。
截至2013年9月，在南卡罗来纳州的13个中心进行了2325次REACH远程中风会诊。在2012年3月至2013年1月期间，对197名接受REACH会诊的患者进行了电话调查，评估他们拨打911的情况。进行单因素和多因素逻辑回归分析，以评估与拨打911相关的因素。
大多数参与者（73%）为白人（27%为非裔美国人），男性占54%。平均年龄为66±14.3岁。与拨打911相关的因素包括美国国立卫生研究院中风量表评分>4（比值比[OR]，5.4；95%置信区间[CI]，2.63-11.25）、未知保险类型（包括自费或未计费，OR，2.90；95%CI，1.15-7.28）以及将类似中风的症状视为紧急情况（OR，4.58；95%CI，1.65-12.67）。非裔美国人拨打911的可能性显著高于白人（62%对43%，P = 0.02）。
非裔美国人拨打911的比例显著更高。拨打911可能与交通便利性、缺乏保险或距离医院较近有关，尽管这些信息并不明确。需要采取干预措施，以改善中风患者到达配备远程医疗设备的急诊科的时间。
