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

Our objective was to determine whether acute ischemic stroke (AIS) patients' language preference is associated with differences in time from symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DTI), and door-to-needle (DTN) time. We identified consecutive AIS patients presenting to a single urban, tertiary, academic center between 01/2003-05/2014 for whom language preference was available. Data were abstracted from the institution's Research Patient Data Registry and Get with the Guidelines-Stroke Registry. Bivariate and regression models evaluated the relationship between language preference and: 1) time from symptom onset to hospital arrival, 2) use of EMS, 3) DTI, and 4) DTN time. Of 3190 AIS patients, 300 (9.4%) were non-English preferring (NEP). Comparing NEP to English preferring (EP) patients in unadjusted or adjusted analyses, time from symptom discovery to arrival and rate of EMS utilization were not significantly different (overall median time 157 min, IQR 55-420; EMS utilization: 65% vs. 61.3% p = 0.21). There was also no significant differences in DTI or in likelihood of guideline-recommended DTI ≤ 25 min (overall median 59 min, IQR 29-127; DTI ≤ 25 min 24.3% vs. 21.3% p = 0.29) or DTN time or in likelihood of guideline-recommended DTN ≤ 60 min (overall median 53 min, IQR 36-73; DTN ≤ 60 min 62.5% vs. 58.2% p = 0.60). Consistent with prior reports examining disparities in care, a systems-based approach to acute stroke prevents differences in hospital-based metrics. Reassuringly, NEP and EP patients also had similar speed of symptom recognition and EMS utilization.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest KSZ, SN, BML, and NIM have no conflicts of interest to disclose. LHS reports the following relationships relevant to research grants or companies that manufacture products for thrombolysis or thrombectomy even if the interaction involves non-thrombolysis products: scientific consultant regarding trial design and conduct to Genentech (late window thrombolysis) and Member of steering committee (TIMELESS NCT03785678); consultant on user interface design and usability to LifeImage; stroke systems of care consultant to the Massachusetts Dept of Public Health; member of a Data Safety Monitoring Boards (DSMB) for Penumbra (MIND NCT03342664) and for Diffusion Pharma PHAST-TSC NCT03763929); Serving as National PI for Medtronic (Stroke AF NCT02700945); National Co-PI, late window thrombolysis trial, NINDS (P50NS051343, MR WITNESS NCT01282242; and alteplase provided free of charge to Massachusetts General Hospital as well as supplemental per-patient payments to participating sites by Genentech); Site PI, StrokeNet Network NINDS (New England Regional Coordinating Center U24NS107243).