Racial disparities in early mortality in 1,134 young patients with acute stroke.
We sought to investigate potential racial disparities in early outcomes of young individuals with stroke in an international multicenter study. We evaluated consecutive patients with first-ever acute stroke aged 18-45 years from prospective databases involving 12 tertiary-care stroke centers in North America (n = 2), Europe (n = 6), and Asia (n = 4). Demographics, vascular risk factors, stroke subtypes, pre-stroke functional status, stroke severity, blood pressure parameters, and serum glucose at hospital admission were documented. The outcome events of interest were 30-day mortality and 30-day favorable functional outcome (FFO) defined as modified-Rankin Scale score of 0-1. A total of 1,134 young adults (mean age 37.4 ± 7.0 years; 58.8 % men; 48.6 % Whites, 23.9 % Blacks, and 27.5 % Asians; median baseline National Institutes of Health Stroke Scale score 6 points, interquartile range 2-13) were included in the analyses. The 30-day stroke mortality and FFO rates differed (p < 0.001) across races. After adjusting for potential confounders, race was independently associated with 30-day mortality (p = 0.026) and 30-day FFO (p = 0.035). Blacks had a fourfold higher odds of 30-day stroke mortality in comparison to Asians (OR 4.00; 95 % CI 1.38-11.59; p = 0.011). Whites also had an increased likelihood of 30-day stroke mortality in comparison to Asians (OR 3.59; 95 % CI 1.28-10.03; p = 0.015). Blacks had a lower odds of 30-day FFO in comparison to Whites (OR 0.57; 95 % CI 0.35-0.91; p = 0.018). Racial disparities in early outcomes following first-ever stroke in young individuals appear to be independent of other known outcome predictor variables. Whites appear to have higher likelihood of 30-day FFO and Asians have lower odds of 30-day stroke mortality.
Second Department of Neurology, School of Medicine, "Attikon" Hospital, University of Athens, Iras 39, Gerakas Attikis, 15344, Athens, Greece, tsivgoulisgiorg@yahoo.gr.
Georgios
G
Tsivgoulis
Jukka
J
Putaala
Vijay K
VK
Sharma
Clotilde
C
Balucani
Sheryl
S
Martin-Schild
Sotirios
S
Giannopoulos
Lokesh
L
Batala
Christos
C
Krogias
Paola
P
Palazzo
Reza
R
Bavarsad Shahripour
Reza Bavarsad
RB
Shahripour
Chrysa
C
Arvaniti
Kristian
K
Barlinn
Daniel
D
Strbian
Elena
E
Haapaniemi
Maria
M
Flamouridou
Konstantinos
K
Vadikolias
Ioannis
I
Heliopoulos
Konstantinos
K
Voumvourakis
Nikos
N
Triantafyllou
Mahmoud Reza
MR
Azarpazhooh
Dimitrios
D
Athanasiadis
Maria
M
Kosmidou
Aristeidis H
AH
Katsanos
Spyros N
SN
Vasdekis
Leonidas
L
Stefanis
Elefterios
E
Stamboulis
Charitomeni
C
Piperidou
Turgut
T
Tatlisumak
Andrei V
AV
Alexandrov
D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D044383:Black People / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology / Q000628:therapy*; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult