Racial Disparities in Prehospital Stroke Care

(HealthDay News) — Black race is associated with prolonged onset to time of arrival intervals with stroke and significantly decreased odds of emergency medical services (EMS) prehospital notification, according to a study published online Sept. 5 in Circulation.

Regina Royan, M.D., from the University of Michigan in Ann Arbor, and colleagues examined how patient-level factors affect these aspects of prehospital stroke care. The analysis included 606,369 patients with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage and symptom onset <24 hours participating in the Get With the Guidelines-Stroke registry (July 2015 to December 2019).

The researchers found that median symptom onset to arrival time was 176 minutes and Black race was significantly associated with prolonged symptom onset to emergency department arrival time (+28.21 minutes). Black race was also associated with decreased odds of EMS prehospital notification (odds ratio [OR], 0.80). There were no associations between the social deprivation index (SDI) and differences in EMS use, but there were lower odds of EMS prehospital notification (upper SDI tercile versus lowest: OR, 0.79). There were significant associations between SDI and stroke symptom onset to emergency department arrival time (upper SDI tercile versus lowest: +2.56 minutes).

“Efforts to reduce place-based disparities in stroke care must address significant inequities in prehospital care of acute stroke and continue to address health inequities associated with race and ethnicity,” the authors write.

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