National stroke educational programs that focus on stroke recognition and appropriate responses may be necessary to receive effective reperfusion therapy for acute ischemic stroke in China, according to a study published Jan. 7 in Stroke.

Shengde Li, MD, et al., sought to determine the national stroke recognition rate and correct action rate of 187,723 adults presenting to 69 administrative areas across China between January and May 2017. The researchers used multivariable logistic regression models to identify factors associated with stroke recognition and intention-to-avail emergency medical services.

Results showed that estimates of stroke recognition rate and correct action rate were 81.9 percent and 60.9 percent, respectively, but varied widely by sociodemographic status, region and stroke risk. The researchers found that approximately one-third of participants who recognized a stroke failed to call emergency medical services.

Furthermore, the researchers found that low likelihood of emergency medical service use was associated with younger age, being male, rural location, high body mass index, low education, low personal income, living with immediate family, having multiple children, having a friend with stroke, exposure to less avenues to learn about stroke, nonsmoking, regular exercise, unknown family history, and no history of cardiovascular disease. Intention of calling emergency medical service was shown to be strongly related to awareness of stroke.

“Substantial discrepancies exist between stroke recognition and correct action, and not all stroke patients know the appropriate responses,” the researchers conclude. “General and broad-based stroke education are needed, not only for individuals at high risk of stroke but also for possible bystanders such as their friends and family.”

Keywords: Stroke, Logistic Models, Brain Ischemia, Body Mass Index, Reperfusion, Emergency Medical Services, Awareness, China

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