Table 4.
Multivariate logistic regression analysis of prehospital delay stratified by urbanization status.
| Variable | Urban | Rural | ||||
|---|---|---|---|---|---|---|
| aOR | 95% CI | p | aOR | 95% CI | p | |
| Fixed effects | ||||||
| Area-level SES (Affluent) | 1 | 1 | ||||
| Middle | 1.06 | (0.92–1.22) | 0.41 | 1.26 | (0.88–1.79) | 0.21 |
| Deprived | 1.24 | (1.04–1.47) | 0.02 | 1.04 | (0.78–1.38) | 0.81 |
| Individual-level SES | ||||||
| High school graduate (below high school) | 0.92 | (0.83–1.01) | 0.09 | 0.95 | (0.81–1.11) | 0.49 |
| Occupation (non-manual) | 1 | 1 | ||||
| Manual | 1.25 | (1.00–1.56) | 0.048 | 0.68 | (0.45–1.02) | 0.06 |
| Other | 1.21 | (0.95–1.53) | 0.12 | 0.64 | (0.41–0.99) | 0.046 |
| Inactive | 1.35 | (1.08–1.69) | 0.01 | 0.72 | (0.47–1.08) | 0.11 |
| National Health Insurance (Medicaid) | 1.03 | (0.82–1.28) | 0.83 | 0.83 | (0.64–1.07) | 0.15 |
| Covariates | ||||||
| EMS use (no) | 0.38 | (0.35–0.42) | <0.001 | 0.42 | (0.37–0.49) | <0.001 |
| Interhospital transfer (no) | 2.12 | (1.86–2.42) | <0.001 | 1.56 | (1.36–1.78) | <0.001 |
| Age group (years) (19–40) | 1 | 1 | ||||
| 40–65 | 1.12 | (0.85–1.48) | 0.44 | 1.17 | (0.76–1.81) | 0.48 |
| ≥65 | 1.22 | (0.92–1.62) | 0.18 | 1.46 | (0.94–2.28) | 0.09 |
| Previous diabetes (no) | 1.28 | (1.15–1.42) | <0.001 | 1.2 | (1.04–1.39) | 0.01 |
| Previous cardiovascular disease (no) | 0.84 | (0.76–0.92) | <0.001 | 0.84 | (0.73–0.95) | 0.01 |
| Exercise (no) | 0.94 | (0.84–1.06) | 0.31 | 0.88 | (0.73–1.05) | 0.15 |
| Onset (day) | 0.76 | (0.69–0.83) | <0.001 | 1.02 | (0.90–1.16) | 0.79 |
| Loss of consciousness (no) | 0.54 | (0.47–0.62) | <0.001 | 0.63 | (0.53–0.74) | <0.001 |
| Recognition of symptoms (no) | 1.12 | (0.98–1.28) | 0.1 | 0.89 | (0.75–1.06) | 0.19 |
| Random effects | ||||||
| Area-level variance | 0.03 | <0.05 | 0.16 | <0.001 | ||
| Intraclass correlation | 0.76 | 4.57 | ||||
Abbreviations: SES—socioeconomic status; OR—odds ratio; CI—confidence interval; EMS—emergency medical service. All references are shown in parentheses. Area and individual-level SES data were adjusted for age group, exercise, diabetes, previous cardiovascular disease, stroke onset time, EMS use, transfer, loss of consciousness, and recognition of symptoms.