Abstract 3930: Differences in Admitting Hospital Characteristics for African American and White Patients with Acute Ischemic Stroke Patients in United States
Background_ Racial disparities in acute ischemic stroke treatment may be due to differences in characteristics of admitting hospitals. Recent studies have found a significantly lower rate of admission for African-American patients with acute myocardial infarction to revascularization centers.
Objective_ To ascertain if there are racial disparities in admitting hospital characteristics in regards to hospital based outcomes and availability of revascularization among patients with ischemic stroke.
Methods_ We identified African-American and white acute ischemic stroke patients from the Nationwide Inpatient Sample-2009. We categorized hospitals based on availability of intravenous thrombolysis (>10 patients per year) and/or endovascular treatment (>1 patient per year). We assessed hospital’s quality using a score based on in-hospital stroke mortality. Hospitals with a score in the top 20% were categorized as high quality, and those in the lowest 20% as low quality. The odds of admission to high or low quality hospitals for white and African American patients was determined after adjusting for risk factors in multivariate analysis.
Results-Of the 110,511 patients admitted with ischemic stroke including 16,334 (14.8%) African-American patients. African-American patients lower mean age (64.7 versus 72.7 years), higher percentage of females (56.5% versus 52.5%) and increased incidence of hypertension (86.6% versus 77.7%) p<0.0001. African American patients were relatively less likely (P<0.001) to be admitted to a high-quality hospitals (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.84 to 0.95) and more likely (P<0.001) to be admitted to low-quality hospitals (OR, 1.16; 95% CI, 1.05 to 1.28). There was no difference in the rates of admission to hospitals with availability of revascularization according to race (OR, 1.026; 95% CI, 0.978 to 1.077).
Conclusions_ There appears to be higher odds for African-American stroke patients to be admitted to low quality hospitals in United States warranting a better understanding of associated factors.
- © 2012 by American Heart Association, Inc.