Abstract W MP99: Race/Ethnic and Sex Differences in EMS Transport among Hospitalized U.S. Stroke Patients: Analysis of the National Get With The Guidelines-Stroke Registry
Background: Calling 911 is the recommended first step when stroke symptoms occur. Differences in activation of emergency medical services (EMS) may contribute to race/ethnic and sex disparities in stroke outcomes. The purpose of this study was to determine whether EMS utilization varies among a contemporary, diverse national sample of hospitalized acute stroke patients.
Methods: We analyzed data from 398,798 stroke patients admitted to 1,613 Get With The Guidelines-Stroke participating hospitals from 10/1/11-3/31/14. Multivariable logistic regression was utilized to evaluate the associations between race/ethnic group and sex, with EMS use, adjusting for potential confounders.
Results: Patients were 50.4% female, 69% white, 19% black, 8% Hispanic, 3% Asian, 1% other; 85.9% ischemic stroke. Overall 58.6% of stroke patients were transported to the hospital by EMS. EMS utilization differed by sex and race/ethnic group (interaction p<0.001). White females were most likely to use EMS (62.0%) and Hispanic males were least likely to (52.2%). Age, health insurance coverage, and history of prior stroke or TIA varied significantly among race/ethnic groups (p<0.0001). After adjustment for both patient and hospital characteristics, Hispanic and Asian men and women were less likely than their white counterparts to utilize EMS; black females were less likely than white females to utilize EMS (Table).
Conclusion: EMS use was low overall and differential by race/ethnicity and sex. These contemporary data support a need for targeted initiatives to increase EMS transport among U.S. stroke patients.
Author Disclosures: H. Mochari-Greenberger: None. Y. Xian: None. A.S. Hellkamp: None. P.J. Schulte: None. D.L. Bhatt: Research Grant; Significant; Amarin, AstraZeneca, Bristol-Myers Squibb, Eisai, Ethicon, Medtronic, Roche, Sanofi Aventis, The Medicines Company. G.C. Fonarow: None. L.H. Schwamm: None. E.E. Smith: None.
This research has received full or partial funding support from the American Heart Association, National Center.
- © 2015 by American Heart Association, Inc.