Barriers from calling ambulance after recognizing stroke differed in adults younger or older than 75 years old in China

Abstract

Background: As health behavior varies with increasing age, we aimed to examine the potential barriers in calling emergency medical services (EMS) after recognizing a stroke among 40-74-and 75-99-year-old adults. Methods: Data were obtained from a cross-sectional community-based study (FAST-RIGHT) that was conducted from January 2017 to May 2017 and involved adults (age ≥ 40 years) across 69 administrative areas in China. A subgroup of residents (153675) who recognized stroke symptoms was analyzed. Multivariable logistic regression models were performed in the 40-74 and 75-99 age groups, separately, to determine the factors associated with wait-and-see behaviors at the onset of a stroke. Results: In the 40-74 and 75-99 age groups, the rates of participants who chose "Self-observation at home"were 3.0% (3912) and 3.5% (738), respectively; the rates of "Wait for family, then go to hospital"were 31.7% (42071) and 33.1% (6957), respectively. Rural residence, living with one's spouse, low income (< 731 US $ per annum), having a single avenue to learn about stroke, and having friends with stroke were factors associated with waiting for one's family in both groups. However, unlike in the 40-74 age group, sex, number of children, family history, and stroke history did not influence the behaviors at stroke onset in the 75-99 age group. Conclusions: Different barriers from recognizing stroke and calling an ambulance exist in the 40-74 and 75-99 age groups in this specific population. Different strategies that mainly focus on changing the "Wait for family"behavior and emphasize on immediately calling EMS are recommended for both age groups.