Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.
Department of Neurosciences, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
Can J Neurol Sci. 2022 Mar;49(2):231-238. doi: 10.1017/cjn.2021.76. Epub 2021 Apr 20.
Prehospital delays are a major obstacle to timely reperfusion therapy in acute ischemic stroke. Stroke sign recognition, however, remains poor in the community. We present an analysis of repeated surveys to assess the impact of Face, Arm, Speech, Time (FAST) public awareness campaigns on stroke knowledge.
Four cross-sectional surveys were conducted between July 2016 and January 2019 in the province of Quebec, Canada (n = 2,451). Knowledge of FAST stroke signs (face drooping, arm weakness and speech difficulties) was assessed with open-ended questions. A bilingual English/French FAST public awareness campaign preceded survey waves 1-3 and two campaigns preceded wave 4. We used multivariable ordinal regression models weighted for age and sex to assess FAST stroke sign knowledge.
We observed an overall significant improvement of 26% in FAST stroke sign knowledge between survey waves 1 and 4 (odds ratio [OR] = 1.26; 95% CI: 1.02, 1.55; p = 0.035). After the last campaign, however, 30.5% (95% CI: 27.5, 33.6) of people were still unable to name a single FAST sign. Factors associated with worse performance were male sex (OR = 0.68; 95% CI: 0.53, 0.86; p = 0.002) and retirement (OR = 0.54; 95% CI: 0.35, 0.83; p = 0.005). People with lower household income and education had a tendency towards worse stroke sign knowledge and were significantly less aware of the FAST campaigns.
Knowledge of FAST stroke signs in the general population improved after multiple public awareness campaigns, although it remained low overall. Future FAST campaigns should especially target men, retired people and individuals with a lower socioeconomic status.
在急性缺血性脑卒中患者中，院前延误是及时再灌注治疗的主要障碍。然而，社区内对中风症状的识别仍然很差。我们对重复调查进行了分析，以评估 Face, Arm, Speech, Time（FAST）公众意识运动对中风知识的影响。
2016 年 7 月至 2019 年 1 月期间，在加拿大魁北克省进行了四项横断面调查（n=2451）。使用开放式问题评估 FAST 中风症状（面部下垂、手臂无力和言语困难）的知识。在调查波 1-3 之前，开展了双语英语/法语 FAST 公众意识运动，在调查波 4 之前，开展了两项运动。我们使用多变量有序回归模型，根据年龄和性别加权，评估 FAST 中风症状知识。
在调查波 1 和 4 之间，我们观察到 FAST 中风症状知识总体上显著提高了 26%（优势比[OR] = 1.26；95%可信区间：1.02，1.55；p = 0.035）。然而，在最后一次运动之后，仍有 30.5%（95%可信区间：27.5，33.6）的人无法说出一个 FAST 症状。表现较差的相关因素包括男性（OR = 0.68；95%可信区间：0.53，0.86；p = 0.002）和退休（OR = 0.54；95%可信区间：0.35，0.83；p = 0.005）。收入和教育程度较低的家庭的人，对中风症状知识的掌握程度较差，对 FAST 运动的知晓率也显著较低。
在多次公众意识运动之后，普通人群对 FAST 中风症状的认识有所提高，但总体上仍较低。未来的 FAST 运动应特别针对男性、退休人员和社会经济地位较低的个人。
