Abstract Details

Title Blacks Are Less Likely To Be Admitted with Transient Ischemic Attack Than Whites in the Bronx

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 197

Objective

Background BACKGROUND: Because the mechanism for TIA is the same as for IS, with only the duration of vascular occlusion and availability of collateral blood flow separating them, the TIA-IS ratio theoretically should be identical across demographic strata. TIA carries high risk of IS but likelihood of hospital admission for TIA may vary by physician or patient behavior.

Design/Methods DESIGN/METHODS: TIA and IS cases were identified from the Montefiore Stroke Registry from January 2009-June 2011 using primary ICD9 discharge codes and confirmed by chart review. Mantel-Haenszel chi-square and Student's t-test were used for univariate and logistic regression for multivariate comparisons.

Results RESULTS: There were 416 TIA and 1762 IS cases confirmed by chart review among white, black and Hispanic patients. Older age (p<0.0001) and male sex (p<0.0001) were associated with lower TIA-IS ratios. Whites (mean age 78 years) were older than blacks (67 years, p<0.0001) and Hispanics (68 years, p<0.0001). In a multivariate model adjusted for hospital site, male sex (TIA-IS OR=0.57, 95% CI 0.45-0.71), older age (0.98, 0.97-0.99) and black race (0.69, 0.55-0.87) were associated with lower TIA-IS ratios.

Conclusions CONCLUSIONS: The TIA-IS ratio differs by age, gender and race, raising the question of whether some groups are less likely to be admitted with TIA than others. We suspect that the differences are related to physician and patient behavior. In particular, blacks, particularly black men, may be less likely to obtain emergency care for TIA symptoms than whites or Hispanics. If confirmed, this finding would support targeting resources for public education on TIA to black Americans.

Authors/Disclosures
Deepa Bhupali, MD (Home) PRESENTER	Dr. Bhupali has nothing to disclose.
Daniel L. Labovitz, MD	An immediate family member of Dr. Labovitz has received personal compensation for serving as an employee of Herrick Feinstein.
Darryl C. De Vivo, MD, FAAN (Columbia University)	Dr. De Vivo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen and Novartis. Dr. De Vivo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aspa Therapeutics.

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