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Racial/Ethnic Disparities in Mortality From Stroke

06/09/2022

Black patients and Hispanic patients have an increased risk of 30-day mortality after stroke when compared with White patients.

To examine racial and ethnic disparities in outcomes by various types of stroke, researchers conducted a retrospective observational study. Included were 37,790 patients from the Veterans Health Administration who were hospitalized for stroke from 2002 to 2012.

Of the total participants, 67% (n=25,492) were non-Hispanic White, 26% (n=9752) were non-Hispanic Black, 7% (n=2546) were Hispanic, and 98% were male. Using the International Classification of Diseases-Nineth Revision codes, acute ischemic stroke (AIS) was diagnosed in 89% of participants, intracerebral hemorrhage (ICH) in 9%, and subarachnoid hemorrhage (SAH) in 2%.

Researchers measured all-cause mortality using the date of death from the National Death Index. Participants were followed up at 30 days or less, 31-90 days, 91 days-1 year, and greater than 1 year.

While Black patients experienced a better 30-day survival after AIS (hazard ratio (HR) 0.80; 95% CI, .8-.94) these patients had a worse 30-day survival after ICH (HR 1.24; 95% CI, 1.06-1.44) when compared with White patients.

Similarly, Hispanic patients had a reduced risk for greater than 1 year mortality after AIS (HR 0.87; 95% CI, .8-.94) but a greater risk of 30-day mortality following SAH (HR 1.61; 95% CI, 1.03-2.52) when compared with White patients.

“In our study, absolute risk of 30-day mortality was 3.2% higher for Black patients after ICH and 10.3% higher for Hispanic patients after SAH, compared [with] White patients,” researchers concluded. “These findings underscore the importance of investigating stroke outcomes by stroke type, to better understand the factors driving observed racial and ethnic disparities.”

 

—Leigh Precopio

 

Reference:

Tarko L, Costa L, Galloway A, et al. Racial and ethnic differences in short- and long-term mortality by stroke type. Neurology. Published online June 1, 2022. https://n.neurology.org/content/early/2022/06/01/WNL.0000000000200575