Language preference does not influence stroke patients' symptom recognition or emergency care time metrics

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• Language preference can be a barrier to healthcare access and quality.
• Understanding potential disparities in acute ischemic stroke (AIS) care is crucial for equitable treatment.
• Previous studies suggest disparities in stroke care based on various patient factors.

Purpose of the Study:

• To investigate if language preference influences key time metrics in acute ischemic stroke (AIS) patient care.
• To compare time from symptom onset to hospital arrival, emergency medical services (EMS) utilization, door-to-imaging time (DTI), and door-to-needle (DTN) time between English and non-English preferring AIS patients.

Main Methods:

• Retrospective analysis of consecutive AIS patients at a tertiary academic center (01/2003-05/2014).
• Data abstracted from institutional registries, including language preference.
• Bivariate and regression models used to assess the relationship between language preference and time-dependent care metrics.

Main Results:

• Of 3190 AIS patients, 300 (9.4%) were non-English preferring (NEP).
• No significant differences were found between NEP and English preferring (EP) patients in time to hospital arrival, EMS utilization, DTI, or DTN times.
• Likelihood of meeting guideline-recommended DTI (≤25 min) and DTN (≤60 min) thresholds was similar between language groups.

Conclusions:

• A systems-based approach to acute stroke care appears to mitigate differences in hospital-based metrics regardless of language preference.
• Language preference was not associated with delays in critical care pathways for AIS patients in this study.
• Findings suggest equitable care delivery concerning time-sensitive metrics for diverse language populations in this academic center.