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Racial Disparity in Mechanical Thrombectomy Utilization: Multicenter Registry Results From 2016 to 2020.
Wallace, Adam N; Gibson, Daniel P; Asif, Kaiz S; Sahlein, Daniel H; Warach, Steven J; Malisch, Timothy; Lamonte, Marian P.
Afiliación
  • Wallace AN; Neurointerventional Surgery Ascension Columbia St. Mary's Hospital Milwaukee WI.
  • Gibson DP; Neurointerventional Surgery Ascension Columbia St. Mary's Hospital Milwaukee WI.
  • Asif KS; Neuroendovascular Surgery and Vascular Neurology Ascension Illinois and Alexian Brothers Medical Center Elk Grove Village IL.
  • Sahlein DH; Interventional Neuroradiology Ascension St. Vincent Hospital Indianapolis IN.
  • Warach SJ; Goodman Campbell Brain and Spine Indianapolis IN.
  • Malisch T; Department of Neurology Ascension Texas and Dell Medical School at The University of Texas at Austin Austin TX.
  • Lamonte MP; Interventional Neuroradiology Ascension Illinois and Alexian Brothers Medical Center Elk Grove Village IL.
J Am Heart Assoc ; 11(4): e021865, 2022 02 15.
Article en En | MEDLINE | ID: mdl-35156390
Background Previous studies on racial disparity in mechanical thrombectomy (MT) treatment of acute large vessel occlusion stroke lack individual patient data that influence treatment decision-making. We assessed patient-level data in a large US health care system from 2016 to 2020 for racial disparities in MT utilization and eligibility. Methods and Results A retrospective study was performed of 34 596 patients admitted to 43 hospitals from January 2016 to September 2020. Data included patient age, sex, race, residential zip code median income and population density, presenting hospital stroke certification, baseline ambulation, and National Institutes of Health stroke scale. The cohort included 26 640 White, non-Hispanic (77.0%), and 7956 African American/Black (23.0%) patients. In multivariable logistic regression, Black patients were less likely to undergo MT (adjusted odds ratio [OR], 0.65; 95% CI, 0.54-0.76), arrive within 5 hours of "last known well" (adjusted OR, 0.73; 95% CI, 0.69-0.78), and have documented anterior circulation large vessel occlusion (adjusted OR, 0.78; 95% CI, 0.64-0.96). Race was not associated with MT rate among patients arriving within 5 hours of last known well with documented acute large vessel occlusion. Conclusions Black patients with stroke underwent MT less frequently than White patients, likely in part because of longer times from last known well to hospital arrival and a lower rate of documented acute large vessel occlusion. Further studies are needed to assess whether extending the MT time window and more aggressive large vessel occlusion screening protocols mitigate this disparity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Am Heart Assoc Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Am Heart Assoc Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido