Race-Ethnic Disparities in Hospital Arrival Time after Ischemic Stroke.
Ethn Dis
; 27(2): 125-132, 2017.
Article
em En
| MEDLINE
| ID: mdl-28439183
ABSTRACT
OBJECTIVE:
Conflicting reports exist about hospital arrival time after stroke onset in Hispanics compared with African Americans and Caucasians. Our current study investigates race-ethnic disparities in hospital arrival times after stroke onset.METHODS:
We performed a retrospective analysis of hospital arrival times in Hispanic, African American, and Caucasian acute ischemic stroke patients (N=1790) presenting to a tertiary-care hospital in the Bronx, New York. A multivariable logistic regression model was used to identify the association between race-ethnicity and hospital arrival time adjusting for age, sex, socioeconomic status (SES), NIH stroke scale (NIHSS), history of stroke, preferred language and transportation mode to the hospital.RESULTS:
There were 338 Caucasians, 662 Hispanics, and 790 African Americans in the cohort. Compared with Caucasians, African Americans and Hispanics were younger (P<.0001 respectively), had lower SES (P<.001 respectively) and were less likely to use EMS (P=.003 and P=.001, respectively). A greater proportion of Hispanic and African American women had delayed hospital arrival times (≥3 hours) after onset of stroke symptoms compared with Caucasian women (74% of Hispanic, 72% of African American, and 59% of Caucasian women), but this difference between race-ethnicities is no longer present after adjusting for socioeconomic status. Compared with Caucasian men, hospital arrival ≥3 hours after symptom onset was more likely for African American men (OR 1.72, 95% CI1.05-2.79) but not Hispanic men (OR .80, 95% CI .49-1.30).CONCLUSIONS:
African American men and socially disadvantaged women delay in presenting to the hospital after stroke onset. Future research should focus on identifying the factors contributing to pre-hospital delay among race-ethnic minorities.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
/
Qualidade da Assistência à Saúde
/
Etnicidade
/
Isquemia Encefálica
/
Atenção à Saúde
/
Disparidades em Assistência à Saúde
/
Tempo para o Tratamento
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article