INTERP: Interpreter requirements needed for tissue plasminogen activator evaluations and resulting performance: a retrospective review

Abstract

Abstract Aim To examine the influence of interpreter service needs (IS) on rt-PA administration time metrics. Methods Retrospectively reviewed prospectively collected data from Comprehensive Stroke Center database (January 2011- April 1, 2021) and EMR. Inclusion: Subjects for whom a “stroke code” was activated. Excluded in-house strokes. Baseline characteristics, frequency of rt-PA, rt-PA exclusions and time metrics, NIHSS were compared between patients who did or did not require IS. Analyses utilized ANOVA, t-Test, Brown-Mood Median Test, or Pearson’s Chi-squared test as appropriate. Results Of 2,191 patients with stroke code activations, 81 had a documented need for IS. Rt-PA was administered in 9 IS and 358 non-IS patients. Median baseline NIHSS was higher in rt-PA group (9±8 vs 3±9, p<0.005). In IS patients, there were no differences in baseline characteristics between those who received rt-PA and those who did not, including median score for NIHSS aphasia (0±1 vs 0±1, p = 0.46). There were no rt-PA rate differences between those that did not and did require IS (17% vs 11%, p = 0.22). In patients with final diagnosis acute ischemic stroke, patients excluded from rt-PA solely due to being out of the window were more likely to have required IS (59% vs 35%, p = 0.003). Time metrics of rt-PA administration were not different in IS patients. Conclusions There was no significant difference in frequency or time metrics of rt-PA administration in patients requiring interpreter services during an acute stroke code. AIS patients requiring an interpreter were more likely to be excluded from rt-PA on the basis of time.

Keywords

• Interpreter
• Language
• Barriers to access
• Health disparities