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Table 1 Characteristics and Responses of Surveyed AIS Patients

From: Why acute ischemic stroke patients in the United States use or do not use emergency medical services transport? Findings of an inpatient survey

 

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

  1. AIS, acute ischemic stroke; EMS, Emergency Medical Services; ER, emergency room; NIHSS, National Institutes of Health Stroke Scale
  2. a Patients with missing sex, age, race, and NIHSS data were transfer patients from another hospital
  3. * P < 0.05 between EMS and non-EMS groups
  4. 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
  5. Responses to the complete list of survey questions are presented in Additional file 1