Abstract TP197: Racial Differences in Comorbidities after Stroke
Introduction: Blacks report more risk factors and more frequent strokes than whites. However, little is known about racial differences in comorbidities after stroke. Examining racial differences in post-stroke comorbidities is important for identifying individuals who may be at particular risk and, ultimately, for promoting better quality of life, fewer secondary strokes, and increased longevity. We assessed the hypothesis that blacks would experience more comorbidities following stroke than whites.
Methods: In 2005, the population-based Greater Cincinnati/Northern Kentucky Stroke Study enrolled a cohort of 460 ischemic stroke patients using hot-pursuit methods. Medical and psychiatric comorbidities were assessed at the 3-month follow-up interview by medical record and self-report. Data from 324 survivors of black or white race were analyzed. Of the 136 not included, 5 were excluded for race, 32 died within 3 months, 20 were lost to follow-up, 14 refused, and 65 did not provide comorbidity data. Comorbidity rates were compared by race using logistic regression.
Results: Black (n=83) and white (n=241) survivors were similar in rates of medical comorbidities after ischemic stroke. There was a significant difference in rates of psychiatric comorbidity (i.e., anxiety, confusion, agitation, depression, hallucinations), with 69% of blacks experiencing psychiatric comorbidities compared with 54% of whites (p < .05). In the unadjusted logistic model, blacks were almost twice as likely to experience psychiatric comorbidities as whites (OR=1.90, 95% CI 1.12-3.23). However, this difference became nonsignificant (OR=1.56, 95% CI 0.88-2.76) after controlling for gender, age, stroke severity, and degree of disability at hospital discharge. In the final model (c statistic=0.69), younger survivors (OR=0.98, 95% CI 0.96-0.99) and those with greater disability (OR=1.58, 95% CI 1.25-1.99) were more likely to experience psychiatric comorbidities, irrespective of race.
Conclusion: Racial differences in comorbidities after stroke appear to be less pronounced than in other areas of disparities research. Age and degree of disability may be more relevant factors than race in determining survivors’ risk for post stroke comorbidities.
- © 2012 by American Heart Association, Inc.