Racial and ethnic disparities in the usage and outcomes of ischemic stroke treatment in the United States.
J Stroke Cerebrovasc Dis
; 32(12): 107393, 2023 Dec.
Article
en En
| MEDLINE
| ID: mdl-37797411
ABSTRACT
OBJECTIVES:
This study explores racial and ethnic differences in 1) receiving tissue plasminogen activator (tPA) and endovascular thrombectomy (EVT) as treatment for ischemic stroke and 2) outcomes and quality of care after use of tPA or EVT in the US. MATERIALS ANDMETHODS:
An observational analysis of 89,035 ischemic stroke patients from the 2019 National Inpatient Sample was conducted. We performed weighted logistic regressions between race and ethnicity and 1) tPA and EVT utilization and 2) in-hospital mortality. We also performed a weighted Poisson regression between race and ethnicity and length of stay (LOS) after tPA or EVT.RESULTS:
Non-Hispanic (NH) Black patients had significantly lower odds of receiving tPA (Adjusted odds ratio [AOR] = 0.85, 95 % Confidence Internal [C.I.] 0.80-0.91) and EVT (AOR = 0.75, 95 % CI 0.70-0.82) than NH White patients. Minority populations (including but not limited to NH Black, Hispanic, Pacific Islander, Native American, and Asian) had significantly longer hospital LOS after treatment with tPA or EVT. We did not find a significant difference between race/ethnicity and in-hospital mortality post-tPA or EVT.CONCLUSIONS:
While we failed to find a difference in in-hospital mortality, racial and ethnic disparities are still evident in the decreased usage of tPA and EVT and longer LOSs for racial and ethnic minority patients. This study calls for interventions to expand the utilization of tPA and EVT and advance quality of care post-tPA or EVT in order to improve stroke care for minority patients.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Accidente Cerebrovascular Isquémico
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Asunto de la revista:
ANGIOLOGIA
/
CEREBRO
Año:
2023
Tipo del documento:
Article