Comparison of stroke process measures and clinical outcomes between English and Non-English preferring patients

• Published in: Journal of stroke and cerebrovascular diseases 2024-09, Vol.33 (9), p.107880, Article 107880
• Main Authors: Le, Dianne, Mullen, Michael T., Lin, Wenxue, Katz, Paul M., Hellerslia, Van
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Disability Evaluation; Female; Functional Status; Healthcare Disparities; Humans; Ischemic Stroke - diagnosis; Ischemic Stroke - therapy; Language; Limited English Proficiency; Male; Middle Aged; Non-English Preferring; Outcome and Process Assessment, Health Care; Patient Discharge; Process Measures; Quality Indicators, Health Care; Recovery of Function; Retrospective Studies; Stroke; Stroke Outcomes; Stroke Rehabilitation; Time Factors; Treatment Outcome
• ISSN: 1052-3057; 1532-8511; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2024.107880

•When compared to English preferring patients, aggregate data on non-English preferring patients with acute stroke fail to show a difference in stroke severity at presentation, clinical care or stroke outcomes.•Among non-English preferring patients, those who prefer a language other than English or Spanish present with significantly more severe strokes than patients who are Spanish preferring and less likely to have independent ambulation at discharge. In the United States, limited English proficiency may reduce the quality of care and worsen outcomes after stroke. The aim was to compare stroke process measures and clinical outcomes between English preferring and non-English preferring stroke patients. This single-center retrospective cohort study evaluated patients from one United States hospital with acute ischemic stroke between July 2013 and June 2022. The primary outcomes were defect-free care, a composite of 7 stroke process measures, and independent ambulation at hospital discharge. Multivariate logistic regression models quantified the association between language preference and outcomes. Secondary outcomes included individual components of defect-free care, discharge modified Rankin scale, and discharge disposition. There were 4,030 patients with acute ischemic stroke identified, of which 2,965 were matched with language data from the electronic medical record. There were 373 non-English preferring patients, among which 76.9% preferred Spanish and 23.1% were non-English, non-Spanish preferring. In the multivariable model, there was no significant association between non-English preference and defect-free care (OR=0.64, 95% CI=0.26-1.59) or independent ambulation at discharge (OR=0.89, 95% CI=0.67-1.17). When compared to Spanish preferring patients, non-English, non-Spanish preferring patients had more severe strokes (P