Analysis of Time to the Hospital and Ambulance Use Following a Stroke Community Education Intervention in China

Abstract

IMPORTANCEPrehospital delay (time from symptom onset of stroke to the door of a hospital) in patients with stroke is long in China. With the goal of improving public awareness and knowledge of stroke recognition, Stroke 1-2-0 was developed in China as an education program to prompt rapid response to the onset of stroke based on clinical practice in China, and examination of its outcomes is needed. OBJECTIVE To investigate the association of the Stroke 1-2-0 educational campaign with prehospital delay for patients with ischemic stroke. DESIGN, SETTING, AND PARTICIPANTSIn a population-based cross-sectional study, all patients with ischemic stroke events were admitted to the Minhang Hospital, which is the only tertiary care hospital with a stroke center that provides acute stroke care in Xinzhuang county, Shanghai, China.

Prehospital stroke management and mobile stroke units

“…As a possible solution to the problem of prehospital delays and poor help-seeking behaviour, public education campaigns have been set up. A most recent before-after study from China found that a persistent, multifaceted campaign increased the rate of arrival at the hospital within 3 h of the event from 5.8 to 33.4% ( P < 0.001) [5].…”

Impact of bilingual face, arm, speech, time (FAST) public awareness campaigns on emergency medical services (EMS) activation in a large Canadian metropolitan area

“…Our findings suggest that the observed increase in EMS calls after individual campaigns for any stroke is not primarily driven by more EMS calls for stroke < 5 h. Our definition of stroke < 5 h, however, is dichotomous (< 5 versus ≥ 5 h), which does not allow the assessment of faster EMS activation on a more refined continuous scale. Prior studies reported that stroke awareness campaigns were associated with increased ambulance use and faster hospital arrival within 3 and 24 h [25,26]. Our definition also encompasses all suspected strokes < 5 h regardless of their severity, whereas prior evidence suggests stroke severity modifies the effect of FAST campaigns on EMS activation [25,26].…”

“…Prior studies reported that stroke awareness campaigns were associated with increased ambulance use and faster hospital arrival within 3 and 24 h [25,26]. Our definition also encompasses all suspected strokes < 5 h regardless of their severity, whereas prior evidence suggests stroke severity modifies the effect of FAST campaigns on EMS activation [25,26].…”

Age and geographic disparities in acute ischaemic stroke prehospital delays in China: a cross-sectional study using national stroke registry data

“…Medline search with appropriate MeSH terms was performed to identify the current gaps in the literature. Data on prehospital delays have been reported in a small number of regional studies in China, 4 , 5 , 6 , 7 , 8 , 9 but little is known at a national level. Many studies were from a single hospital in China.…”