Which stroke symptoms prompt a 911 call? A population-based study

Kleindorfer, Dawn; Lindsell, Christopher J.; Moomaw, Charles J.; Alwell, Kathleen; Woo, Daniel; Flaherty, Matthew L.; Adeoye, Opeolu; Zakaria, Tarek; Broderick, Joseph P.; Kissela, Brett M.

doi:10.1016/j.ajem.2009.02.016

Cited by 54 publications

(35 citation statements)

References 17 publications

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“…Respondents from Europe and America cited other signs, such as aphasia, facial palsy, headache, difficulty in speaking or understanding, blurred and double vision, slurred speech and weakness, more often than Africans [13,14,15]. Furthermore weakness is the symptom most associated with increased calls for Emergency Medical Services in those countries [16]. The reason for these differences is possibly that the dominant presentation with weakness on one side of the body has overshadowed other forms of presentations of the disease in West Africa.…”

Section: Discussionmentioning

confidence: 99%

Knowledge of Stroke among an Urban Population in Cotonou (Benin)

et al. 2012

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Background: Studies on the knowledge of stroke, its related risk factors and warning symptoms in the populations of Sub-Saharan Africa are scarce. No study has been performed in Benin until now. Methods: A door-to-door survey was performed in two districts of Cotonou with a broad socioeconomic range. 15,155 individuals aged ≥15 years were interviewed using a semi-structured questionnaire adapted from previous reports. Results: 15,155 individuals consented to participate in the survey. 14.1% correctly identified the brain as the affected organ in stroke. The most commonly identified risk factor was hypertension (34.5%). The most often cited warning signs of stroke were paralysis and hemiplegia (34.4%). Relatives were the major source of information about stroke (25.1%). In multivariate analysis, age, education level, occupation, self-reported risk factors of stroke, overweight and obesity were associated with at least one correct response to the questionnaire about stroke risk factors or symptoms. Conclusion: The awareness of stroke, and its risk factors and symptoms is low in Cotonou. The results suggest that specific education programs may improve people’s knowledge of stroke and their awareness of related risk factors in Sub-Saharan African countries.

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Section: Discussionmentioning

confidence: 99%

Knowledge of Stroke among an Urban Population in Cotonou (Benin)

et al. 2012

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“…Robinson et al [23] reported that symptoms not included in the FAST campaign (leg weakness and visual loss) were poorly recognized by British people and indicated that this lack of knowledge might lead to delays in hospital presentation. Actually, in the Greater Cincinnati/Northern Kentucky Stroke Study, it was found that stroke/transient ischemic attack patients with numbness or visual changes were less likely to contact emergency medical services [24]. To call an ambulance and go as an emergency to the hospital, people who have stroke attacks and bystanders must recognize that it is a stroke, no matter which early symptom is observed.…”

Section: Discussionmentioning

confidence: 99%

Public Awareness of Early Symptoms of Stroke and Information Sources about Stroke among the General Japanese Population: The Acquisition of Stroke Knowledge Study

Miyamatsu

Okamura²,

Nakayama³

et al. 2013

Cerebrovasc Dis

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Background: It is important that the general population be aware of the early symptoms, since it has been shown that early arrival to hospitals leads better prognosis of stroke patients. However, the general population is not well informed about the early symptoms of stroke. This study was conducted to clarify which stroke symptoms are less well known and which information sources are related to awareness of stroke symptoms. Methods: A multiple-choice, mail-in survey involving 5,540 randomly selected residents, aged 40-74 years, of 3 cities in Japan was conducted. Their knowledge about stroke symptoms and their information sources were surveyed; information sources were classified as mass media (television/newspaper/radio) and personal communication sources (posters/leaflets/internet/health professionals/family and/or friends). ‘Awareness' was defined as selecting all 5 of the correct stroke symptoms from among 10 listed symptoms with decoy choices. The estimated fraction of the possible impact due to each source on the whole population was also calculated by odds ratios (ORs) and the proportion of respondents who selected each source (Pe). The combined effects of mass media and personal communication sources on awareness were also assessed. Results: Of the 5,540 residents, only 23% selected all 5 correct symptoms. Visual disturbance was the least known of the 5 symptoms (35%). All sources were positively related to awareness, with ORs (Pe) of: television, 1.58 (72.5%); newspaper, 1.79 (48.0%); radio, 1.74 (13.3%); posters, 1.73 (7.6%); leaflets, 1.50 (24.7%); Internet, 1.66 (5.6%); health professionals, 1.33 (34.8%), and family/friends, 1.21 (44.6%). The estimated fraction of the possible impact due to each source was higher for mass media (television, 0.31 and newspaper, 0.28) than personal communication sources (Internet, 0.04 and leaflets, 0.12). Mass media only and mass media/personal communication sources were significantly associated (ORs: 1.66, 2.75, respectively). Conclusions: As a single method of public education, television could be the most effective strategy. Moreover, the combined approach involving mass media and personal communication sources might have a synergistic effect. Less well-known symptoms, such as visual disturbances, should be noted in public education campaigns.

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“…Many efforts have been made to analyze the factors which affect prehospital delay in acute stroke patients (5)(6)(7)(8)(9)(10)(11). It has been previously reported that stroke-related symptoms may contribute to prehospital delay; however, the extent of this contribution differs for each symptom (12). Stroke-related symptoms have been analyzed based on signs which were diagnosed by the physicians, not based on symptoms recognized by the patients or bystanders.…”

Section: Introductionmentioning

confidence: 99%

Prehospital Delay and Stroke-related Symptoms

et al. 2015

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Objective Prehospital delay is the major cause of treatment delay in stroke. This study was conducted to clarify the contribution of specific stroke-related symptoms to prehospital delay. Methods A consecutive series of 469 patients hospitalized within 2 weeks of stroke onset was collected. In this study, prehospital delay was defined as the time interval from recognition of stroke-related symptoms to hospital arrival. The prevalence of each symptom or sign and prehospital delay were analyzed. Results Weakness of the lower limb (43.5%) was the most common symptom followed by weakness of the upper limb (37.1%) and dysarthria (31.6%). Conversely, the most common sign was weakness of the upper limb (54.1%) followed by dysarthria (53.3%), weakness of the lower limb (53.1%), and sensory disturbance (39.0%). The presence of confusion/decreased level of consciousness (p<0.001), aphasia (p<0.001), headache (p=0.017), and nausea/vomiting (p=0.035) were associated with earlier hospital visitation compared with the absence of these symptoms in univariate analyses. Conversely, the presence of sensory disturbance (p= 0.0017) and vertigo/dizziness (p=0.044) were associated with a significant delay in hospital visitation compared with the absence of these symptoms. There was a discrepancy in the prevalence between symptoms recognized by the patients or bystanders and signs diagnosed by the physicians. Conclusion There was a significant overall correlation between prehospital delay and the National Institute of Health Stroke Scale scores. Public education is therefore necessary to encourage early hospital visitation even with the appearance of mild symptoms.

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Which stroke symptoms prompt a 911 call? A population-based study

Cited by 54 publications

References 17 publications

Knowledge of Stroke among an Urban Population in Cotonou (Benin)

Knowledge of Stroke among an Urban Population in Cotonou (Benin)

Public Awareness of Early Symptoms of Stroke and Information Sources about Stroke among the General Japanese Population: The Acquisition of Stroke Knowledge Study

Prehospital Delay and Stroke-related Symptoms

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