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1	Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines-Stroke Registry.
	Mochari-Greenberger, Heidi; Xian, Ying; Hellkamp, Anne S. - : Ovid Technologies (Wolters Kluwer Health), 2020
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2	Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines-Stroke Registry.
	Mochari-Greenberger, Heidi; Xian, Ying; Hellkamp, Anne S; Schulte, Phillip J; Bhatt, Deepak L; Fonarow, Gregg C; Saver, Jeffrey L; Reeves, Mathew J; Schwamm, Lee H; Smith, Eric E
	In: Journal of the American Heart Association, vol 4, iss 8 (2015)
	Abstract: BackgroundDifferences in activation of emergency medical services (EMS) may contribute to racial/ethnic and sex disparities in stroke outcomes. The purpose of this study was to determine whether EMS use varied by race/ethnicity and sex among a current, diverse national sample of hospitalized acute stroke patients.Methods and resultsWe analyzed data from 398,798 stroke patients admitted to 1613 Get With The Guidelines-Stroke participating hospitals between October 2011 and March 2014. Multivariable logistic regression was used to evaluate the associations between combinations of racial/ethnic and sex groups with EMS use, adjusting for potential confounders including demographics, medical history, and stroke symptoms. Patients were 50% female, 69% white, 19% black, 8% Hispanic, 3% Asian, and 1% other, and 86% had ischemic stroke. Overall, 59% of stroke patients were transported to the hospital by EMS. White women were most likely to use EMS (62%); Hispanic men were least likely to use EMS (52%). After adjustment for patient characteristics, Hispanic and Asian men and women had 20% to 29% lower adjusted odds of using EMS versus their white counterparts; black women were less likely than white women to use EMS (odds ratio 0.75, 95% CI 0.72 to 0.77). Patients with weakness or paresis, altered level of consciousness, and/or aphasia were significantly more likely to use EMS than patients without each symptom; the observed racial/ethnic and sex differences in EMS use remained significant after adjustment for stroke symptoms.ConclusionsEMS use differed by race/ethnicity and sex. These contemporary data document suboptimal use of EMS transport among US stroke patients, especially by racial/ethnic minorities and those with less recognized stroke symptoms.
	Keyword: African Americans; Aged; Asian Americans; Attitudes; Cardiorespiratory Medicine and Haematology; Chi-Square Distribution; disparities; Emergency Medical Services; European Continental Ancestry Group; Female; Health Knowledge; Hispanic Americans; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Patient Acceptance of Health Care; Practice; race/ethnicity; Registries; sex; Sex Factors; Stroke; Transportation of Patients; United States
	URL: https://escholarship.org/uc/item/0c76q0pf
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