22. European Stroke Conference 737 Acute cerebrovascular events (ACE): TIA and minor strokes The Effect of FAST Awareness on Patient Response to TIA like Symptoms. D. Dutta1, M. Price2, A. Kumar3, A. Deering4, K. Hellier5 Gloucestershire Royal Hospital, Gloucester, UNITED KINGDOM1, Gloucestershire Royal Hos-pital, Gloucester, UNITED KINGDOM2, Gloucestershire Royal Hospital, Gloucester, UNITED KINGDOM3, Gloucestershire Royal Hospital, Gloucester, UNITED KINGDOM4, Gloucestershire Royal Hospital, Gloucester, UNITED KINGDOM5 Background: Effective management of stroke and TIA is dependent upon an urgent response from patients at symptom onset. Public education programmes such as FAST (Face, Arm, Speech, Time to call 999) may increase awareness of stroke symptoms but knowledge about response to transient symptoms amongst FAST aware patients is limited. Methods: A survey of consecutive patients attending a UK hospital TIA clinic between October and December 2012 following recent neurological symptoms. Our results were compared with 2 earli-er studies before the launch of the FAST campaign. Data were collected by 5 clinicians and tests of proportion and the Wilcoxon rank sum tests were used for analysis. Results: Of 209 patients (50.7% male; median age 73.0), TIA was diagnosed in 43.1%, 16.3% had strokes and 40.7% were stroke mimics. Although 59.3% were FAST aware, only 10% could recall all 4 elements and only 26.6% of FAST aware patients acknowledged that their response had been influenced by FAST. Median time to first medical contact was 18 hours for FAST aware patients and 24 hours for unaware (p=0.220). An emergency response (calling 999/attending A&E) was not-ed in 32.3% of FAST aware versus 21.2% of unaware patients (p=0.079). Of FAST aware patients not influenced by FAST, 30.4% were unable to remember FAST when symptoms occurred, 43.5% failed to realise that their symptoms could represent a stroke and 10.9% failed to recall the appropri-ate emergency response. The proportion of patients presenting within 3 hours of onset was 34.4% versus 44.2% (p=0.012) in an earlier study. The proportion presenting within 24 hours of onset was 61.2% vs. 70% (p=0.017) and 55.6% (p=0.265) in 2 earlier studies. Conclusions: The FAST campaign did not influence response in patients with transient or minor symptoms in this study. Future public awareness campaigns must be continued for long enough to leave a lasting impression, focus on an emergency response and highlight other important symptoms of stroke. 734 © 2013 S. Karger AG, Basel Scientific Programme Table 1: FAST knowledge and response of FAST aware and unaware patients. FAST aware (n= 124) FAST unaware (n= 85) p FAST knowledge: Aware of 0 items Aware of 1 item Aware of 2 items Aware of 3 items Aware of all 4 items 29.8% 16.2% 22.8% 20.5% 10.0% N/A N/A Response to sym-ptoms: Called 999 Presented to ED Saw GP Called friends/ fa-mily Did nothing 15.4% 17.1% 52.0% 4.9% 10.6% 10.6% 10.6% 55.3% 16.5% 7.1% p= 0.079 Onset to first me-dical contact in hours (median, upper and lower quantiles) 18 (0.5, 48) 24 (2,72) p =0.220 Table 2: Comparison of current and 2 older (pre FAST) studies. This stu-dy, 2012 (n=209) Giles, 2006 (n=241) Chandratheva, 2010 (n=1000) p Age in years (mean) 69.3 71.0 73.0 p=0.367 Response time (% of pati-ents): 34.4% N/A 44.2% p=0.012 < 3 hours 61.2% 55.6% p=0.265 < 24 hours 61.2% 70% p=0.017 < 24 hours Emergency response- cal-ling 999 or presentation to ED (% of patients) 27.6% 9.9% 17.5% P<0.001
Karger_ESC London_2013
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