Public Stroke Knowledge: Does a Link Exist Between the

Presence of Risk Factors and Knowledge of Warning Signs?

Zachary Jarou, Nathaniel Harris, Liza Gill Meena Azizi, Shayef Gabasha, Robert LaBril Michigan State University College of Human Medicine

• stroke is the 3rd leading cause of death in the United States

• also the primary cause of

severe, long-term adult disability, significantly burdening the health care system

Backg

rou

nd

• only 1-8% of ischemic stroke patients in the US receive thrombolytics

• 73% are excluded secondary to

delay in seeking medical attention after the onset of stroke symptoms 

Backg

rou

nd

Does a correlation exist between:P

urp

ose # of stroke risk 

factors present in an individual

their ability to correctly identify warning signs

?

Hypothesis• In an ideal world, it would be great if

those at greatest risk knew what to look for

• In the real world, we predict that those at greatest will be the least able to identify the warning signs of stroke

• cross-sectional survey• 245 members of the public • grocery stores and malls at medium-size

university town in Midwest • 17 multiple-choice items– 6 warning signs (yes/no/unsure)– 7 past medical history (yes/no/maybe)– 4 demographic (gender, age,

education, PCP)• MSU IRB x13-139eM

eth

od

s

• data was analyzed using Stata (version 12)

• frequency of responses for each variable– prevalence of risk factors– ability to identify warning signs– demographic information

• univariate analysis– t-test = knowledge by gender– ANOVA = knowledge by level of

education & # risk factors• multivariate regression analysis

Meth

od

s

Resu

lts

• The median age of respondents was 40, with a range from 18 to 88 years old.

Resu

lts

Resu

lts

• This study suggests that individuals with an increased number of modifiable stroke risk factors are less able to correctly identify stroke warning signs compared to healthier individuals.

• The results also suggest that some stroke symptoms are more easily recognizable to the public than others.

• These findings should be replicated in larger and more representative samples before developing future stroke awareness campaigns.

Con

clu

sio

ns

• # of symptom foils• have risk factors been screened for?• quantifying tobacco & alcohol use• quantifying frequency of PCP visits• small # of subjects with 3+ risk

factors, low level of education• effect of open ended questions

Lim

itati

on

s

AHA Statistical Update: Heart Disease and Stroke Statistics 2011; 123:e18-e209.

Barber et al. Why are stroke patients

excluded from TPA therapy? An analysis of patient eligibility. Neurology 2001; 56:1015-1020.

Kleindorfer et al. Temporal Trends in

Public Awareness of Stroke Warning Signs, Risk Factors, and Treatment. Stroke 2009, 40:2502-2506.

Refe

ren

ces

Questions?

Thank you to our mentors!Henry Barry MD, Clare Luz PhD, Carlos

Rios MPH ScD Department of Family MedicineMichigan State University College of

Human Medicine