Abstract Details

Title Race Influences the Recovery from Acute Stroke Interventions

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 150

Objective

Background BACKGROUND: Racial disparities exist in various aspects of stroke epidemiology and access to health care. Social and biological differences between the races put African Americans (AA) at a relative disadvantage.

Design/Methods DESIGN/METHODS: A retrospective chart review of adult ischemic stroke patients receiving endovascular interventions at an urban medical center was conducted. Demographics, risk factors, pre-treatment NIHSS, baseline functional status and time to treatment were abstracted. Patients received chemical interventions (intra-arterial tPA or intravenous and intra-arterial tPA); mechanical interventions (MERCI clot retrieval, Penumbra aspiration, Solitaire stentrieval), or multimodal intervention (chemical and mechanical methods). Outcomes included death, hemorrhagic conversion, modified rankin score (mRS) at discharge and discharge destination. 128 patients (35.2% Caucasian; 64.8% AA) were included.

Results RESULTS: AA had more hypertension (87.9% vs 71.1%;p=0.02) and less hypercholesterolemia (62.7% vs 80%;p=0.04) than Caucasians. There were no differences among other risk factors. The median age and NIHSS were not significantly different. There were no statistically significant differences in the variety of chemical, mechanical or multimodal interventions offered to AA and Caucasians. Time to treatment was similar between races. In a univariate analysis, AA race predicted discharge to a subacute rehabilitation facility or nursing home (45.9% vs 25% among Caucasians; p=0.04). There were no racial differences in in-hospital death and mRS at discharge. In a multivariate regression model with backward selection, AA strongly predicted discharge to a subacute rehabilitation facility or nursing home, while Caucasians were more likely to be discharged home or to acute rehabilitation.

Conclusions CONCLUSIONS: Race is a strong predictor of home and rehabilitation discharge favoring Caucasians. Biological and social mechanisms underlying racial disparities in stroke care and access to interventions may also extend to stroke recovery and post-stroke rehabilitation care.

Authors/Disclosures
Monica B. Dhakar, MBBS (Xenon Pharmaceuticals) PRESENTER	Dr. Dhakar has received personal compensation for serving as an employee of Xenon Pharmaceuticals Inc. Dr. Dhakar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell Inc. Dr. Dhakar has or had stock in Xenon Pharmaceuticals Inc. The institution of an immediate family member of Dr. Dhakar has received research support from NIH. The institution of an immediate family member of Dr. Dhakar has received research support from Medtronics.
Kumar Rajamani, MD, FAAN	Dr. Rajamani has nothing to disclose.
Barry A. Singer, MD	Dr. Singer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Singer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Singer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Singer has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for TG Therapeutics. Dr. Singer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb (Celgene). Dr. Singer has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for EMD Serono. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Singer has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Novartis. Dr. Singer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Singer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Vanda. An immediate family member of Dr. Singer has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for TG Therapeutics. The institution of Dr. Singer has received research support from Novartis. The institution of Dr. Singer has received research support from Sanofi. The institution of Dr. Singer has received research support from TG Therapeutics. The institution of Dr. Singer has received research support from Bristol Myers Squibb.
Ramesh Madhavan, MD, FAAN (International Medical Clinic)	Dr. Madhavan has received stock or an ownership interest from TiaTech USA and TiaTech India. Dr. Madhavan has received intellectual property interests from a discovery or technology relating to health care.
Gregory Norris, MD (DetroitBrainInstitute)	No disclosure on file
Sandra Narayanan, MD, FAAN	Dr. Narayanan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Narayanan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MicroVention.
Samuel Tsappidi, MD (University of Florida Dept of Neurosurgery)	No disclosure on file
Andrew Xavier, MD (Neuro Team One)	No disclosure on file
Seemant Chaturvedi, MD, FAHA, FAAN (University of Maryland)	Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Chaturvedi has received research support from NINDS.
Pratik D. Bhattacharya, MD, MPH (International Medical Clinic)	Dr. Bhattacharya has a non-compensated relationship as a Research Advisor with Defeat MSA Alliance 501 (c) (3) that is relevant to AAN interests or activities.

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