Spanish Version of the National Institutes of Health Stroke Scale: Awareness and Use in United States. a Survey Study

Abstract

Objective—To investigate the awareness and the use of Spanish version of National Institutes of Health
Stroke Scale (NIHSS) throughout the United States (US) by regions using a web-based survey.
Methods—A survey targeting physicians from two specialties that regularly manage acute stroke patients
was conducted from February to August of 2015. Academic centers from the Accreditation Council for
Graduate Medical Education online directory belonging to emergency medicine (EM) and neurology residency programs were identified. The questionnaire was composed of ten questions separated into three different groups. The responses received from the programs were separated by specialty and grouped into different regions in the US for comparison.
Results—Out of 230 residency-invited programs, we received a total of 73 responses, 35 from EM and 26
responses from neurology residency programs. In addition, 12 respondents were categorized as unknown
recipients. The South region had the highest response rate with 30.3%. There was no significant difference
in the responses by region if Puerto Rico was not analyzed. Interviewees reported a substantial percentage
of Spanish-speaking patients reported across the regions and more than 75% of the programs report lack of
knowledge of the Spanish version of the NIHSS and/or the use of it.
Conclusion—There may be a need to increase awareness and to promote the use of the Spanish version
of the NIHSS. Spanish-speaking population in the US may be inaccurately assessed for acute stroke and
could impact the outcomes. Larger population studies should be conducted to confirm our findings.
Author contributions—Dr. Villalobos and Dr. Barnes are involved in formulating the study concept and
design; Dr. Rodriguez and Dr. Maud are involved in manuscript writing; Dr. Qureshi is involved in statistical analysis of the data; Dr. Cruz-Flores is involved in critical revision of the manuscript.
Disclosures—Dr. Villalobos reports no disclosure; Dr. Barnes reports no disclosure; Dr. Qureshi reports
no disclosure; Dr. Cruz-Flores reports no disclosure; Dr. Maud reports no disclosure; Dr. Rodriguez reports
no disclosure