RESUMO
The Racial disparity between the clinical outcomes poststroke have not been well studied, with limited literature available. We conducted a meta-analysis to evaluate the poststroke outcomes among the White and Black race of patients. We systematically searched all electronic databases from inception until March 1, 2023. The primary endpoint was post stroke in-hospital mortality, and all-cause mortality. Secondary endpoints were poststroke intervention in-hospital mortality, intracerebral hemorrhage, and all-cause mortality (ACM). A total of 1,250,397 patients were included in the analysis, with 1,018,892 (81.48%) patients of the White race and 231,505 (18.51%) patients in the Black race. The mean age of the patients in each group was (73.55 vs 66.28). The most common comorbidity among White and Black patients was HTN (73.92% vs 81.00%), and DM (29.37% vs 43.36%). The odds of in hospital mortality post stroke (OR, 1.45 [95% CI:1.35-1.55], P <0.001), and all-cause mortality (OR, 1.40 [95% CI:1.28-1.54], P < 0.001) were significantly higher among White patients compared with Black patients. Among patients with post stroke intervention the odds of in-hospital mortality (OR, 1.29 (95% CI: 1.05-1.59, Pâ¯=â¯0.02), and intracerebral hemorrhage (ICH) (OR, 1.15, [95% CI:1.06-1.26], P < 0.01) were significantly higher among White patients compared with Black patients post intervention. However, all-cause mortality (OR,1.21 [95% CI: 0.87-1.68, Pâ¯=â¯0.25] was comparable between both groups. Our study is the most comprehensive and first meta-analysis with the largest sample size thus far, highlighting that White patients are at increased risk of mortality and post intervention intracerebral hemorrhage compared with Black patients.
Assuntos
Acidente Vascular Cerebral , Humanos , Negro ou Afro-Americano , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/etnologia , Hemorragia Cerebral/etiologia , Grupos Raciais/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/terapia , População Branca , Avaliação de Resultados em Cuidados de Saúde , Mortalidade Hospitalar , IdosoRESUMO
The association between nonalcoholic fatty liver disease (NAFLD) with cardiovascular and cerebrovascular outcomes, as well as their clinical impact, has yet to be established in the literature. This meta-analysis aims to evaluate the association between the NAFLD patients and the risk of atrial fibrillation (AF), heart failure (HF), stroke, cardiovascular mortality (CVM), and revascularization incidence. We performed a systematic literature search using PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until August 2022. A total of 12 cohort studies with 18,055,072 patients (2,938,753 NAFLD vs 15,116,319 non-NAFLD) were included in our analysis. The mean age of the NAFLD patients group and the non-NAFLD group was comparable (55.68 vs 55.87). The most common comorbidities among the NAFLD patients group included hypertension (38% vs 24%) and diabetes mellitus (14% vs 8%). The mean follow-up duration was 6.26 years. The likelihood of AF (risk ratio (RR), 1.42 (95% CI 1.19, 1.68), p < 0.001), HF (RR, 1.43(95% CI 1.03, 2.00), p < 0.001), stroke (RR, 1.26(95% CI 1.16, 1.36), p < 0.001), revascularization (RR, 4.06(95% CI 1.44, 11.46), p = 0.01), and CVM (RR, 3.10(95% CI 1.43, 6.73), p < 0.001) was significantly higher in the NAFLD patients group compared to that of the non-NAFLD group. However, all-cause mortality was comparable between both the groups of patients (RR, 1.30 (95% CI 0.63, 2.67), p = 0.48). In conclusion, the patients with NAFLD are at increased risk of AF, HF, and CVM.