Abstract TP210: Declining number of stroke patients arriving within 4.5 hours in a multiethnic community

Introduction: Despite public education efforts over the past 30 years, about one in four strokes occur in people who already have had a stroke. Despite nationwide campaigns to raise stroke awareness, recent data from years 2014 through 2023 (Ferrone et al., 2025) demonstrates that there was a significant decline in the number of patients presenting to emergency departments within the 0-4.5-hour treatment window. According to our Primary Stroke Center data, 50% fewer patients presented within the accepted thrombolytic window to our ED in 2025 compared to 2024. We designed a project to assess patient's reasons for delays in presenting to emergency department with stroke. We are seeking to learn which barriers are specific to our local multiethnic patient population. Methods: We created a questionnaire to assess patients’ reasons for not presenting to ED immediately when they started experiencing stroke symptoms. A 10-question survey is administered to suspected stroke or TIA patients who are admitted to our hospital for stroke or TIA. The survey asks about patients’ education level and their primary language. Initial questions are directed to whether the patient knows any stroke symptoms and whether they knew they were having a stroke. If not, then the patient is educated on stroke symptoms, time sensitive stroke treatments, and the importance of activating EMS. If the patient responds that they knew that they were having a stroke, they are asked to complete the remaining questions about what they did next. Results: This is a study in progress and only preliminary data is available. The data from the pilot group of 20 patients who completed the survey between June 1, 2025, and August 18, 2025, shows that 70% of patients were not aware they were having a stroke. Of those who did know they were having a stroke, most stated reluctancy to go to ED as their primary reason for not calling EMS. Eighty percent of so far surveyed patients have not had any prior stroke education. More complete data will be available at the time of this presentation. Conclusion: We expect that this survey will provide additional information on reasons for not activating EMS immediately when someone is experiencing stroke symptoms in our local multiethnic community. From our pilot group, it is already evident that there is a significant need for community stroke education directed to various ethnic groups in their primary language.