The role of ethnicity, sex, and language on delay to hospital arrival for acute ischemic stroke.

BACKGROUND AND PURPOSE Use of emergency medical services has been shown to decrease transport and triage times for stroke. Mexican Americans and women experience a large stroke burden. The objective of this study was to compare time to hospital arrival and emergency medical services use for stroke care by ethnicity, sex, and language preference among Mexican American and non-Hispanic white ischemic stroke patients. METHODS The Brain Attack Surveillance in Corpus Christi (BASIC) project is a population-based study in south Texas. All stroke cases were identified by active or passive surveillance and validated by neurologists. Logistic regression models assessing time to hospital arrival and emergency medical services use were analyzed. RESULTS There were 1134 ischemic stroke cases ascertained between January 1, 2000, and December 31, 2006. Mexican Americans were less likely than non-Hispanic whites to arrive by emergency medical services (odds ratio, 0.6; 95% CI, 0.4, 0.8). Men were more likely than women to present to the hospital within 3 hours (odds ratio, 0.7; 95% CI, 0.5, 0.9); language was not associated with study outcomes. CONCLUSIONS Sex and ethnic differences in hospital presentation were found in this community. There is a need to promote an urgent response to stroke symptoms, especially in groups that experience the greatest stroke burden.