Racial and Ethnic Disparities in Functional Outcome after Thrombectomy: A Cohort Study of an Integrated Stroke Network.
Black or African American
/ statistics & numerical data
Aged
Ethnicity
/ statistics & numerical data
Health Status Disparities
Hispanic or Latino
/ statistics & numerical data
Humans
Ischemic Stroke
/ ethnology
Middle Aged
Racial Groups
/ statistics & numerical data
Retrospective Studies
Thrombectomy
Treatment Outcome
White People
/ statistics & numerical data
Disparities
Outcomes
Racial
Thrombectomy
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
30
03
2021
revised:
11
09
2021
accepted:
17
09
2021
pubmed:
17
10
2021
medline:
9
2
2022
entrez:
16
10
2021
Statut:
ppublish
Résumé
Previous studies have shown racial disparities in access to treatment and outcomes in ischemic stroke patients. We sought to define racial disparities in functional outcomes among ischemic stroke patients receiving endovascular thrombectomy (EVT). We performed a retrospective review of patients in our institution's prospectively collected stroke patient registry from 08/2015 to 06/2019 at 1 comprehensive and 2 thrombectomy-ready stroke centers. We reviewed patients aged ≥ 18 who received mechanical thrombectomy including only patients with race/ethnicity data belonging to the 3 largest race/ethnic groups: Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Hispanic (HIS). We compared baseline characteristics and performed multivariable logistic regression to evaluate differences in good functional outcome defined as 90-day modified Rankin score (90 day mRS 0-2) as the primary outcome. Secondary outcomes were discharge disposition, length of stay, and excellent functional outcome (90 day mRS 0-1). Results are given as OR [95% CI]. Among 666 patients that met inclusion criteria, 45% were NHW, 30% were NHB, and 19% were HIS. NHB and HIS patients were younger than NHW (average age NHB 62; HIS 64; and NHW 70; p < 0.001). Diabetes was more prevalent in NHB (32%, p = 0.02) and HIS (47%, p < 0.001) compared to NHW (23%). There were no significant racial differences in pre-morbid mRS, arrival NIHSS, tPA treatment rates. There was no difference in primary outcome by race comparing NHW to the other racial groups (OR 1.08 [0.68-1.72]) but compared to HIS patients, NHW had a higher likelihood of the secondary outcome of excellent functional outcome (aOR 2.23 [1.01-4.93]) defined as mRS 0-1. In this study of over 600 patients treated with EVT, we did not find significant racial disparities in functional outcome except for less excellent functional outcome in HIS compared to NHW. Further study on disparities in post-acute stroke care is needed.
Identifiants
pubmed: 34655973
pii: S1052-3057(21)00536-X
doi: 10.1016/j.jstrokecerebrovasdis.2021.106131
pmc: PMC8578430
mid: NIHMS1742940
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106131Subventions
Organisme : NINDS NIH HHS
ID : T32 NS007412
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003167
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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