04 Jul Blacks and Asians Have Lower Mortality Than Whites After Ischemic Stroke
MedicalResearch.com Interview with:
Nilay Kumar M.B.B.S.
Attending physician at Cambridge Health Alliance, Cambridge, MA
Instructor in Medicine at Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Racial differences in stroke mortality have major health policy implications. A large body of evidence has shown significant racial differences in the incidence of stroke and associated mortality rate (death due to stroke per unit population per year) in the United States. Few studies to date have addressed racial differences in in-hospital outcomes after acute ischemic stroke using population level datasets. Previous studies have shown inconsistent results with respect to racial differences in in-hospital case fatality rate after acute ischemic stroke. Additionally, racial minorities have been known to be less likely to receive evidence based reperfusion therapies for several cardiovascular diseases including acute myocardial infarction and ischemic stroke. Previous studies on racial differences in stroke outcomes have rarely included Asian and Pacific Islanders. Against this background, we aimed to ascertain racial differences in outcomes of acute ischemic stroke hospitalization in the US using a nationally representative sample.
MedicalResearch.com: What should readers take away from your report?
Response: We found significant racial differences in patient characteristics and outcomes of acute ischemic stroke related hospitalization in the US population. In patients hospitalized for ischemic stroke, atrial fibrillation was significantly more common in Whites compared with Blacks while hypertension and diabetes were significantly more common in Blacks compared with Whites. Blacks and Hispanics were about 10% less likely to receive thrombolysis compared with Whites and approximately 20% less likely to undergo endovascular reperfusion. Despite the lower utilization of reperfusion therapies among Blacks compared with Whites, the in-hospital case fatality rate was about 30% lower in Blacks compared with Whites and 20% lower in Asians compared with Whites.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future studies should identify reasons for lower utilization of reperfusion therapies in ischemic stroke in Blacks compared with Whites. Future studies should evaluate whether lower in-hospital case fatality rate among Blacks compared with Whites is explained by differences in stroke severity and pathophysiology (lacunar vs. cardioembolic stroke).
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Racial differences in outcomes after acute ischemic stroke hospitalization in the United Statesz
Nilay Kumar, Rohan Khera, Ambarish Pandey, Neetika Garg
Journal of Stroke and Cerebrovascular Diseases, May 2016 PMID 27212273
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