Abstract Body: Background: Ischemic stroke is a medical emergency necessitating prompt neurological evaluation and treatment. Standard of care is an initial CT Head within 25 minutes of patient arrival. Literature has shown that English language proficiency can lead to delays in evaluation by emergency medicine providers. In this study, we evaluate the effect of language preference on door to imaging (DIT) time for patients presenting with strokes symptoms.
Methods: This was a retrospective study of patients enrolled in the Video-based Intervention to reduce Treatment and Outcome Disparities in Adults Living with Stroke or TIA (VIRTUAL) study from March 2022 to June 2023. Enrolled patients complete a 4-item language preference questionnaire which is used to assessed limited English proficiency (LEP). We used the question “Which language do you prefer for receiving verbal communication about health-related information?” to determine which patients had LEP. Door to CT time was used for DIT. Individual medical records were reviewed and “arrival time” and CT result time was abstracted to calculate DIT. We used Wilcoxon rank sum test to compare door to CT time between patients with and without LEP. We aimed to utilize a multiple linear regression model to evaluate the association between LEP and door to CT time after adjusting for age, sex, race, NIHSS and stroke type.
Results: We included 152 patients with ischemic stroke, TIA, or hemorrhagic stroke who presented to our ED with stroke symptoms. LEP was found in 23 (15%) of patient. The median DIT for patients with LEP was 42 minutes (mean 100) vs 25 minutes (mean 67) for those without LEP. There was no significant difference between these two times in univariate analysis (p=0.21) or in adjusted analysis (P=0.59).
Conclusions: This study did not demonstrate a statistically significant difference in median DIT between those who preferred to use English and those who preferred another language. However, this study was limited by small sample size and significant variance in the data set. The next step would be to include additional patients to determine if the signal seen here reflects a true difference in assessment according to language proficiency.