Abstract TP257: Is Non-English Language Correlated to Inaccurate Initial "Last Known Normal" Reports by Emergency Responders?

Abstract

Background: Prior studies have looked into language and race disparities in receiving IV thrombolysis, however none into its correlation in obtaining accurate Last Known Normal (LKN) times that critically guide decision-making for acute stroke treatment. We sought to assess if non-English language preference was associated with inaccurate initial reporting of LKN time by emergency responders compared to LKN obtained by neurologists. Methods: Data was obtained from an IRB approved stroke registry in a single center from July 2013 to December 2018, for LKN time documented by a neurologist (“LKN2”). Manual chart review was done to document 1st reported LKN time as documented by EMS (or ED if no runsheets available) (“LKN1”). Inpatient stroke codes and hospital transfers were excluded. Differences in LKN1 and LKN2 were computed and stratified into Groups A (LKN1 is earlier in time than LKN2), B (LKN1 is the same as LKN2), and C (LKN1 is later in time than LKN2). Spearman correlation was used to analyze language differences; race between groups were compared using ANOVA. Results: Of total 990 stroke codes, 59.9% had discrepancy in LKN1 and LKN2 (17.9% in Group A, 42% in Group C) whereas 40.1% had agreeable LKN1 and LKN2 (Group B). Data for preferred language and race was available in 985 and 950 stroke codes, respectively. Language preference for English versus non-English is listed in Table 1, where no difference was found when Groups A and C (discrepant LKN1 and LKN2) was compared to Group B (p=0.68). Race of each group is listed in Table 2, where no difference was noted among Groups A, B, C as well (p=0.68). Conclusion: Non-English language preference among patients did not correlate with inaccurate reporting of LKN times by emergency responders. There were no significant racial differences found as well between groups with discrepant and agreeable LKN1 and LKN2 times.