African American patients have a higher probability of cognitive impairment after incident stroke: An analysis of national electronic health record data.
J Stroke Cerebrovasc Dis
; 33(8): 107787, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38806108
ABSTRACT
BACKGROUND:
Cognitive impairment (CI) and stroke are diseases with significant disparities in race and geography. Post stroke cognitive impairment (PSCI) can be as high as 15-70 % but few studies have utilized large administrative or electronic health records (EHR) to evaluate trends in PSCI. We utilized an EHR database to evaluate for disparities in PSCI in a large sample of patients after first recorded stroke to evaluate for disparities in race.METHODS:
This is a retrospective cohort analysis of Cerner Health Facts® EHR database, which is comprised of EHR data from hundreds of hospitals/clinics in the US from 2009-2018. We evaluated patients ≥40 years of age with a first time ischemic stroke (IS) diagnosis for PSCI using ICD9/10 codes for both conditions. Patients with first stroke in the Cerner database and no pre-existing cognitive impairment were included, we compared hazard ratios for developing PSCI for patient characteristicsRESULTS:
A total of 150,142 IS patients with follow-up data and no pre-existing evidence of CI were evaluated. Traditional risk factors of age, female sex, kidney injury, hypertension, and hyperlipidemia were associated with PSCI. Only African American stroke survivors had a higher probability of developing PSCI compared to White survivors (HR 1.347, 95 % CI (1.270, 1.428)) and this difference was most prominent in the South. Among those to develop PSCI, median time to documentation was 1.8 years in African American survivors.CONCLUSION:
In a large national database, African American stroke survivors had a higher probability of PSCI five years after stroke than White survivors.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Negro ou Afro-Americano
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Bases de Dados Factuais
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População Branca
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Registros Eletrônicos de Saúde
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Disfunção Cognitiva
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article