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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.
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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. - : Ovid Technologies (Wolters Kluwer Health), 2020
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Abstract:
Differences 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.We 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.EMS 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.
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Keyword:
African Americans; Aged; Asian Americans; Attitudes; Chi-Square Distribution; 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; Registries; Sex Factors; Stroke; Transportation of Patients; United States
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URL: https://hdl.handle.net/10161/21833
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| 2 |
Geographical variation in the prevalence of heavy drinking in young Swiss men.
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In: European journal of public health, vol. 26, no. 5, pp. 850-855 (2016)
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| 3 |
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.
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In: Journal of the American Heart Association, vol 4, iss 8 (2015)
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| 5 |
Intelligence in childhood and chronic widespread pain in middle age: the National Child Development Survey.
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In: Symplectic Elements at Oxford ; Europe PubMed Central ; PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) ; Web of Science (Lite) (http://apps.webofknowledge.com/summary.do) ; Scopus (http://www.scopus.com/home.url) ; CrossRef (2012)
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| 6 |
"I know I have arthritis but I don't know what type". Understanding and knowledge of this chronic condition
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| 7 |
Decomposing self-estimates of intelligence: structure and sex differences across 12 nations.
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In: Br J Psychol , 100 (Pt 2) 429 - 442. (2009) (2009)
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| 8 |
Consciência fonêmica em meninos e meninas Phonemic awareness in boys and girls
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In: Revista da Sociedade Brasileira de Fonoaudiologia, Vol 14, Iss 2, Pp 205-211 (2009) (2009)
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| 9 |
Indigenous children and receipt of hospital dental care in Australia
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| 10 |
Development of the Grammar and Phonology Screening (GAPS) test to assess key markers of specific language and literacy difficulties in young children.
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In: Int J Lang Commun Disord , 41 (5) pp. 513-540. (2006) (2006)
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| 11 |
The relationship between lower urinary tract symptoms and health status: the UREPIK study.
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In: Symplectic Elements at Oxford ; Europe PubMed Central ; PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) ; Web of Science (Lite) (http://apps.webofknowledge.com/summary.do) ; Scopus (http://www.scopus.com/home.url) ; CrossRef (2003)
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| 12 |
The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study.
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In: Symplectic Elements at Oxford ; Europe PubMed Central ; PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) ; Scopus (http://www.scopus.com/home.url) ; CrossRef (2003)
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| 14 |
"Twin language": a risk factor for language impairment?
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In: Symplectic Elements at Oxford ; Europe PubMed Central ; PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) (1998)
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| 15 |
Estimating the incidence of cancers in Switzerland: 1983-1987.
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In: European Journal of Cancer, vol. 30A, no. 7, pp. 978-982 (1994)
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| 16 |
Characteristics of patients with language disorders and the theory of multiple intelligences
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In: Revista CEFAC, Vol 19, Iss 5, Pp 629-644
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