Table 1.
Characteristics and Responses of Surveyed AIS Patients
| All surveyed patients (n = 108) No (%) |
Classified by EMS use | ||
|---|---|---|---|
| Yes (n = 75) No (%) |
No (n = 33) No (%) |
||
| Patient characteristics | |||
| Sexa* | |||
| -Male | 47 (48.5) | 31 (45.6) | 16 (55.2) |
| -Female | 50 (51.5) | 37 (54.4) | 13 (44.8) |
| Age, mean (SD) | 63.5 ± 15.4 | 64.3 ± 15.4 | 61.6 ± 15.6 |
| Racea* | |||
| -White/Asian/Other | 54 (55.7) | 32 (47.1) | 22 (75.9) |
| -Black/African American | 43 (44.3) | 36 (52.9) | 7 (24.1) |
| Severity based on initial NIHSSa* | |||
| -Mild (NIHSS 0–5) | 57 (59.4) | 33 (49.3) | 24 (82.8) |
| -Moderate (NIHSS 6–15) | 27 (28.1) | 23 (34.3) | 4 (13.8) |
| -Severe (NIHSS ≥16) | 12 (12.5) | 11 (16.4) | 1 (3.4) |
| Alteplase at study hospitala* | 14 (14.4) | 14 (20.6) | 0 |
| Comorbidities/Risk factorsb, mean (SD) | 2.4 ± 1.5 | 2.4 ± 1.4 | 2.4 ± 1.7 |
| Response to selected survey questions | |||
| Symptoms | |||
| -Had ≥1 typical stroke symptom | 90 (83.4) | 62 (82.7) | 28 (84.9) |
| -Thought of stroke and perceived symptom as relevant and indicating possible stroke (not dismissing the symptom)* | 74 (68.5) | 67 (89.3) | 7 (21.2) |
| -Awake at stroke onset | 81 (75.0) | 60 (80.0) | 21 (63.6) |
| Knowledge of symptoms | |||
| -Knew some typical stroke symptoms | 72 (66.7) | 48 (64.0) | 24 (72.8) |
| -Knew no symptom | 36 (33.3) | 27 (36.0) | 9 (27.3) |
| -Familiar with stroke experience due to personal history or family/friend with stroke* | 79 (73.2) | 60 (80.0) | 19 (57.6) |
| Knew the importance of quick treatment /ambulance arrival for good outcome* | 27 (25.0) | 27 (36.0) | 0 |
| Influence of social networks | |||
| -Family member/bystander discouraged patient from calling 911* | 10 (9.3) | 2 (2.7) | 8 (24.2) |
| -Family member/bystander supported patient thoughts to call 911* | 33 (30.6) | 33 (44.0) | 0 |
| Reported financial concerns about ambulance use/concern about cost of ambulance use | 21 (19.4) | 11 (14.7) | 10 (30.3) |
| Prior experience of or expectation of long ER wait time* | 2 (1.9) | 0 | 2 (6.1) |
| Live out in the country, better to drive personally to reach quickly* | 10 (9.3) | 1 (1.3) | 9 (27.3) |
| Role of personal physician or their staff | |||
| -Patient reported being educated about stroke symptoms by their doctor or nurse | 37 (34.3) | 27 (36.0) | 10 (30.3) |
| -Physician’s office directed the patient to actions other than calling 911 when symptoms occurred* | 6 (5.6) | 0 | 6 (18.2) |
| Source of stroke knowledge | |||
| -Physician/nurse/personal stroke experience | 55 (50.9) | 36 (48.0) | 19 (57.6) |
| -Public sources (internet, billboards, etc.) | 30 (27.8) | 23 (30.7) | 7 (21.2) |
| -No stroke knowledge | 23 (21.3) | 16 (21.3) | 7 (21.2) |
| Previous experience with ambulance | |||
| -Had prior experience of self/family members with calling 911 for ambulance* | 63 (58.3) | 51 (68.0) | 12 (36.4) |
| -Had a bad ambulance use experience | 3 (2.8) | 2 (2.7) | 1 (3.0) |
| Concerns about ED medical staff’s negative affective response due to personal health habits or other reasons | 0 | 0 | 0 |
AIS, acute ischemic stroke; EMS, Emergency Medical Services; ER, emergency room; NIHSS, National Institutes of Health Stroke Scale
a Patients with missing sex, age, race, and NIHSS data were transfer patients from another hospital
* P < 0.05 between EMS and non-EMS groups
bGWTG (Get With The Guidelines)stroke-relevant conditions/risk factors: atrial fibrillation/flutter, coronary artery disease/prior myocardial infarction, carotid stenosis, depression, diabetes mellitus, drugs/alcohol abuse, dyslipidemia, heart failure, hypertension, migraine, obesity/overweight, previous stroke, previous transient ischemic attack, peripheral vascular disease, renal insufficiency, sleep apnea and smoking history
Responses to the complete list of survey questions are presented in Additional file 1