Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States | Zendy

Charles Esenwa | Zendy; Alain Lekoubou | Zendy; Kinfe G. Bishu | Zendy; Kemar Small | Zendy; Ava L. Liberman | Zendy; Bruce Ovbiagele | Zendy

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Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

Author(s) -

Charles Esenwa,

Alain Lekoubou,

Kinfe G. Bishu,

Kemar Small,

Ava L. Liberman,

Bruce Ovbiagele

Publication year - 2020

Publication title -

ethnicity and disease

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.767

H-Index - 67

eISSN - 1945-0826

pISSN - 1049-510X

DOI - 10.18865/ed.30.1.91

Subject(s) - medicine , stroke (engine) , ethnic group , cohort , retrospective cohort study , demography , population , emergency medicine , physical therapy , environmental health , mechanical engineering , sociology , anthropology , engineering

Background: Compared with non-Hispanic Whites (NHW), racial-ethnic minorities bear a disproportionate burden of stroke and receive fewer evidence-based stroke care processes and treatments. Since 2015, mechanical thrombectomy (MT) has become standard of care for acute ischemic stroke (AIS) patients with proximal anterior circulation large vessel occlusion (LVO).Objectives: Our objectives were to: assess recent trends in nationwide MT utilization among patients with AIS; determine if there were racial differences; and identify what factors were associated with such differences.Methods: We performed a retrospective cohort study using nationally representative data of a non-institutionalized population sample from 2006 to 2014 obtained from the Nationwide Inpatient Sample (NIS). We identified a total of 889,309 observations of AIS, of which there were 5,256 MT observations.Results: In the fully adjusted model, rate of thrombectomy utilization was significantly lower in African Americans (AA) (OR .67, CI .58-.76, P<.001) compared with NHW and Hispanics (OR .94, CI .78-1.13, P=.5).Conclusion: We found a significant disparity in MT utilization for AA compared with NHW and Hispanics. More work is needed to understand the drivers of this racial disparity in stroke treatment. Ethn Dis. 2020;30(1):91-96; doi:10.18865/ed.30.1.91

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