Abstract TP305: Primary Language Has No Affect on Onset to Emergency Arrival Time or Door to Needle Time for Intravenous Thrombolysis

Abstract

Objective: To determine if primary language affects acute ischemic stroke evaluation and door-to-needle time for intravenous (IV) tissue plasminogen activator (tPA). Methods: This is a retrospective study of acute ischemic stroke patients at our center from January 2013 to December 2016. Charts were reviewed to identify preferred language. Data were collected from the Get With the Guidelines Database, including last known well (LKW)-to-door time, door-to-imaging time and door-to-needle time. Patients were divided into English and non-English speaking groups. The non-English speaking group was further divided into Spanish, Vietnamese, and Other groups. Mann Whitney test was used to assess differences between the English and Non-English groups for LKW-to-door time and door-to-imaging time. A chi-squared test was used for pairwise comparisons of English, Non-English, Spanish, Vietnamese, and Other language groups to assess whether language affects likelihood of receiving tPA. Results: The study included 1,118 ischemic stroke patients; 188 received IV tPA. Among them 758 were English speaking and 360 non-English speaking patients (196 Spanish, 101 Vietnamese and 63 other language speaking minorities). Between the non-English and English speaking groups there was no significant difference in the average last known well-to-door time (275 minutes vs. 224 minutes p=0.29), door-to-imaging time (23 minutes vs. 22 minutes, p=0.47) and door-to-needle time (51 minutes vs. 55 minutes, p=0.37). In subgroup analyses primary language was not found to have a significant effect on LKW-to-door time for language groups when compared to English. Also, there is no a significant difference for non-English groups when compared to English who present to the hospital within 24 hours of symptom onset. Conclusions: Primary language had no significant effect on door-to-needle time for IV tPA or LKW-to-door time. Yet, about one fourth of all patients arrived greater than 24 hours of symptom onset which excludes them from receiving treatment. Increasing targeted community stroke education is essential to help improve recognition of stroke symptoms and timely presentation to stroke centers.