Abstract Details

Title Racial Disparities with Last Known Normal Time in patients with Acute Ischemic Stroke

Topic Health Care Disparities

Presentation(s) S18 - Health Care Disparities (4:24 PM-4:32 PM)

Poster/Presentation
Number 003

Objective We sought to determine whether racial disparities exist in documentation of last known normal (LKN) time as known versus unknown.

Background

Racial disparities have been reported in stroke care, including acute treatment with intravenous tissue plasminogen activator (IVtPA) and mechanical thrombectomy. Establishing accurate LKN is essential to determine a patient’s eligibility for time-sensitive acute ischemic stroke treatments.

Design/Methods We retrospectively reviewed ischemic stroke patients at our comprehensive stroke center from December 2013 to April 2019. Data was abstracted on demographics, LKN, and IVtPA administration. Known LKN was defined as documentation of a specific time including date and hour. Unknown LKN was characterized as date only or completely unknown (both date and time unknown).

Results Among 3963 patients hospitalized for acute ischemic stroke, mean age was 66.7 years (range, 16 - 100), 1882 (47.5%) were female, and 991 (25%) received IVtPA. The patient population was predominantly white, with 3132 (79%) white, 704 (17.8%) black, and 127 (3%) other/unknown. Compared to white patients, black patients were younger (mean age 63.1 vs 67.6, p <0.0001) and less likely to receive IVtPA (12.9% vs 27.4%, p <0.0001). LKN was known in 3000 (75.7%) and unknown in 963 (24.3%). Mean age was younger in unknown LKN compared to known LKN (64.9 vs 67.3 years, p <0.0001). Blacks were significantly less likely to have known LKN compared to whites (57.5% vs 79.9%, p <0.0001). Among those with unknown LKN, date was known in 803 (83.1%) and completely unknown in 160 (16.9%), with no difference in completely unknown LKN between blacks and whites (16.4% vs 17.0%, p 0.6).

Conclusions In a tertiary stroke center with predominantly white patients, black patients were more likely to have LKN documented as unknown compared to white patients, which is an explicit barrier to acute stroke treatment. Further studies are warranted to better understand these discrepancies.

Authors/Disclosures
Mangala Gopal, MD (Teladoc) PRESENTER	Dr. Gopal has nothing to disclose.
Vivien H. Lee, MD, FAAN (OSU Comprehensive Neurovascular Center)	Dr. Lee has nothing to disclose.

��ɫ��

��ɫ��