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Stroke symptoms, risk factors awareness and personal decision making in Chile. A national survey

  • Victor Navia
    Affiliations
    Unidad de Neurología, Hospital Padre Hurtado, Santiago, Chile

    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile

    Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Enrico Mazzon
    Affiliations
    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile

    Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Verónica V. Olavarría
    Affiliations
    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Juan Almeida
    Affiliations
    Unidad de Neurología, Hospital Padre Hurtado, Santiago, Chile

    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Alejandro M. Brunser
    Affiliations
    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Pablo M. Lavados
    Affiliations
    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Lorena Hoffmeister
    Affiliations
    Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
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  • Paula Muñoz Venturelli
    Correspondence
    Corresponding author.
    Affiliations
    Unidad de Neurología Vascular, Servicio de Neurología, Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile

    Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile

    The George Institute for Global Health, University of New South Wales, Sydney, Australia
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      Highlights

      • Almost a quarter of Chileans did not recognize at least one typical symptom of stroke.
      • Recognition of stroke symptoms and prompt presentation to the emergency depends on age and SES group.
      • There is a need for tailored educational campaigns.

      Abstract

      Background

      Knowledge about stroke symptoms, correct decision in front of a stroke case and recognition of stroke risk factors are crucial to fight against stroke burden. We aimed to assess the stroke awareness among a sample of the Chilean population.

      Methods

      A closed-ended questions structured survey was applied in November 2019 using a computer-assisted telephone interviewing system. Probabilistic sample, random selection and stratification for region was used. Multivariate logistic regression model was used to estimate the association between participants’ characteristics and responses.

      Results

      Of 706 participants, only 74.4% (95% CI 70.9-77.5) recognized at least one typical stroke symptom. Most (586, 82.4% 95% CI 75.2-89.7) chose to contact the emergency ambulance or directly go to the emergency department in case of a stroke symptom and recognized at least one risk factor (692, 97.9% CI 96.7-98.8). In multivariable analysis, sociodemographic characteristics associated to a worse recognition of at least one stroke symptom were being men (OR 0.67, 95% CI 0.47-0.96), being 55 years old or older (OR 0.59 95% CI 0.37-0.93) and from the lowest socioeconomic level (SES) (OR 0.33 95% CI 0.16-0.67). Female sex was associated with lower stroke risk factor knowledge (OR 0.64 95% IC 0.47-0.87). Participants who recognized at least one typical stroke symptom and would promptly seek care at an emergency department differed significantly between SES (p=0.001) and age groups (p=0.035).

      Conclusions

      We found insufficient knowledge about stroke symptoms and best decisions making in the Chilean population. We describe gaps that can be targeted in future stroke awareness campaigns. There is a need to strengthen tailored stroke education particularly for underserved populations.

      Key Words

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      References

        • CO Johnson
        • Nguyen M
        • Roth GA
        • et al.
        Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.
        Lancet Neurol. 2019; 18: 439-458
      1. Institute for Health Metrics and Evaluation. Global Burden of Disease Compare Data Visualization [Internet]. Available from: healthdata.org/gbd-compare/

      2. Departamento de estadísticas de información de salud, DEIS. Estadística de egresos hospitalarios; tendencia por año según patología. Estadística de defunciones por causa básica de muerte. [Internet]. Available from: deis.minsal.cl/

        • Hoffmeister L
        • Lavados PM
        • Comas M
        • et al.
        Performance measures for in-hospital care of acute ischemic stroke in public hospitals in Chile.
        BMC Neurol. 2013; 13: 23
        • Avezum Á
        • Costa-Filho FF
        • Pieri A
        • et al.
        Stroke in Latin America: Burden of Disease and Opportunities for Prevention.
        Glob Heart. 2015; 10: 323
        • Hawkes MA
        • Ameriso SF
        • Willey JZ.
        Stroke Knowledge in Spanish-Speaking Populations.
        Neuroepidemiology. 2015; 44: 121-129
        • Ouriques Martins SC
        • Sacks C
        • Hacke W
        • et al.
        Priorities to reduce the burden of stroke in Latin American countries.
        Lancet Neurol. 2019; 18: 674-683
        • Clark JM
        • Renier SA.
        A community stroke study: factors influencing stroke awareness and hospital arrival time.
        J Stroke Cerebrovasc Dis. 2001; 10: 274-278
        • Pontes-Neto OM
        • Silva GS
        • Feitosa MR
        • et al.
        Stroke awareness in Brazil: alarming results in a community-based study.
        Stroke. 2008; 39: 292-296
        • Martins SCO
        • Lavados P
        • Secchi TL
        • et al.
        Fighting against stroke in Latin America: a joint effort of medical professional societies and governments.
        Front Neurol. 2021; 12743732
        • Harbison J
        • Hossain O
        • Jenkinson D
        • et al.
        Diagnostic accuracy of stroke referrals from primary care, emergency room physicians, and ambulance staff using the face arm speech test.
        Stroke. 2003; 34: 71-76
        • O'Donnell MJ
        • Chin SL
        • Rangarajan S
        • et al.
        Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study.
        Lancet. 2016; 388: 761-775
      3. Asociación de Investigadores de Mercado y Opinión Pública. Actualización 2019: Clasificación grupos socioeconómicos y manual de aplicación [Internet]. Available from: aimchile.cl/wp-content/uploads/2022/03/Actualizacio%CC%81n-y-Manual-GSE-AIM-2019-1.pdf

        • Schneider AT
        • Pancioli AM
        • Khoury JC
        • et al.
        Trends in Community Knowledge of the Warning Signs and Risk Factors for Stroke.
        JAMA. 2003; 289: 343
        • Meira F
        • Magalhães D
        • da Silva LS
        • et al.
        Knowledge about stroke in Belo Horizonte, Brazil: a community-based study using an innovative video approach.
        Cerebrovasc Dis Extra. 2018; 8: 60-69
        • Akiyama H
        • Hasegawa Y.
        Stroke knowledge: a nationwide, internet-based survey of 11,121 inhabitants in Japan.
        Intern Med. 2013; 52: 529-537
        • Dossi DE
        • Hawkes MA
        • Pujol-Lereis VA
        • et al.
        A Population-Based Survey of Stroke Knowledge in Argentina: The SIFHON Study.
        Neuroepidemiology. 2019; 53: 32-40
        • Committee on Health Care Utilization and Adults with Disabilities, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine
        Health-Care Utilization as a Proxy in Disability Determination [Internet].
        National Academies Press, Washington, D.C.2018 ([cited 2022 Jul 14]. Available fromncbi.nlm.nih.gov/books/NBK500097/)
        • Marshall IJ
        • Wang Y
        • Crichton S
        • et al.
        The effects of socioeconomic status on stroke risk and outcomes.
        Lancet Neurol. 2015; 14: 1206-1218
        • Avan A
        • Digaleh H
        • Di Napoli M
        • et al.
        Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017.
        BMC Med. 2019; 17: 191
        • Rosengren A
        • Smyth A
        • Rangarajan S
        • et al.
        Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study.
        Lancet Glob Health. 2019; 7: e748-e760
        • Powers WJ
        • Rabinstein AA
        • Ackerson T
        • et al.
        Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
        Stroke [Internet]. 2019; 50 ([cited 2022 Feb 17]Available fromahajournals.org/doi/10.1161/STR.0000000000000211)
      4. Boland M, Sweeney M, Scallan E, et al. Emerging advantages and drawbacks of telephone surveying in public health research in Ireland and the U.K. BMC Public Health. 2006;6( ):208.

      5. Taub A. ‘Chile Woke Up’: Dictatorship's Legacy of Inequality Triggers Mass Protests. Available from: nytimes.com/2019/11/03/world/americas/chile-protests.html