Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (R.M., J.L.). Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (S.M., H.M.K.). Section of Cardiovascular Medicine, Department of Internal Medicine (S.M., H.M.K.) and Department of Neurology (R.K.), Yale School of Medicine, New Haven, CT. Division of Cardiovascular Prevention and Wellness (J.V.-E., M.C.-A., K.N.) and Center for Outcomes Research (K.N.), Houston Methodist DeBakey Heart and Vascular Center, TX. Houston Methodist Research Institute, TX (T.Y.). University of Texas Southwestern Medical Center, Dallas (R.S.). Department of Medicine, Medstar Union Memorial Hospital, Baltimore, MD (G.R.G.). Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX (S.S.V.). Department of Medicine, West Virginia University School of Medicine, Morgantown (S.U.K.). Center for Outcomes Research, Houston Methodist Neurological Institute, TX (F.S.V.).
Stroke. 2020 Dec;51(12):3552-3561. doi: 10.1161/STROKEAHA.120.031137. Epub 2020 Oct 26.
Despite declining stroke rates in the general population, stroke incidence and hospitalizations are rising among younger individuals. Awareness of and prompt response to stroke symptoms are crucial components of a timely diagnosis and disease management. We assessed awareness of stroke symptoms and response to a perceived stroke among young adults in the United States.
Using data from the 2017 National Health Interview Survey, we assessed awareness of 5 common stroke symptoms and the knowledge of planned response (ie, calling emergency medical services) among young adults (<45 years) across diverse sociodemographic groups. Common stroke symptoms included: (1) numbness of face/arm/leg, (2) confusion/trouble speaking, (3) difficulty walking/dizziness/loss of balance, (4) trouble seeing in one/both eyes, and (5) severe headache.
Our study population included 24 769 adults, of which 9844 (39.7%) were young adults who were included in our primary analysis, and represented 107.2 million US young adults (mean age 31.3 [±7.5] years, 50.6% women, and 62.2% non-Hispanic White). Overall, 2718 young adults (28.9%) were not aware of all 5 stroke symptoms, whereas 242 individuals (2.7%; representing 2.9 million young adults in the United States) were not aware of a single symptom. After adjusting for confounders, Hispanic ethnicity (odds ratio, 1.96 [95% CI, 1.17-3.28]), non-US born immigration status (odds ratio, 2.02 [95% CI, 1.31-3.11]), and lower education level (odds ratio, 2.77 [95% CI, 1.76-4.35]), were significantly associated with lack of symptom awareness. Individuals with 5 high-risk characteristics (non-White, non-US born, low income, uninsured, and high school educated or lower) had nearly a 4-fold higher odds of not being aware of all symptoms (odds ratio, 3.70 [95% CI, 2.43-5.62]).
Based on data from the National Health Interview Survey, a large proportion of young adults may not be aware of stroke symptoms. Certain sociodemographic subgroups with decreased awareness may benefit from focused public health interventions.
尽管普通人群中的中风发病率有所下降，但年轻人的中风发病率和住院率却在上升。对中风症状的认识以及对其的快速反应是及时诊断和疾病管理的重要组成部分。我们评估了美国年轻人对中风症状的认识以及对感知到的中风的反应。
我们使用 2017 年全国健康访谈调查的数据，评估了不同社会人口统计学群体中年轻成年人（<45 岁）对 5 种常见中风症状的认识以及对计划反应（即拨打紧急医疗服务）的了解程度。常见的中风症状包括：（1）面部/手臂/腿部麻木，（2）意识混乱/言语困难，（3）行走困难/头晕/失去平衡，（4）单眼或双眼视力障碍，以及（5）剧烈头痛。
我们的研究人群包括 24769 名成年人，其中 9844 名（39.7%）为年轻成年人，他们被纳入了我们的主要分析，代表了美国 1.072 亿年轻成年人（平均年龄 31.3[±7.5]岁，50.6%为女性，62.2%为非西班牙裔白人）。总体而言，2718 名年轻成年人（28.9%）不知道所有 5 种中风症状，而 242 名个体（2.7%；代表美国 290 万年轻成年人）不知道任何一种症状。在调整混杂因素后，西班牙裔（优势比，1.96[95%可信区间，1.17-3.28]）、非美国出生的移民身份（优势比，2.02[95%可信区间，1.31-3.11]）和较低的教育水平（优势比，2.77[95%可信区间，1.76-4.35]）与缺乏症状意识显著相关。具有 5 种高危特征（非白人、非美国出生、低收入、无保险和高中学历或以下）的个体对所有症状缺乏意识的可能性几乎高出 4 倍（优势比，3.70[95%可信区间，2.43-5.62]）。
基于全国健康访谈调查的数据，很大一部分年轻人可能不知道中风症状。一些意识较低的特定社会人口统计学亚组可能受益于有针对性的公共卫生干预。
