Abstract Details

Title Palliative Care Consultation in Ischemic Stroke: Nationwide Disparities and Predictors

Topic Palliative Care

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-013

Objective We aimed to examine demographic disparities and clinical predictors of palliative care consultation (PCC) in ischemic stroke hospitalizations in the United States (US) from 2016 to 2022.

Background Ischemic stroke is a leading cause of mortality and long-term disability in the US. PCC facilitates goals-of-care discussions, reduce non-beneficial interventions, and improve patient-centered outcomes. There is paucity of large scale data on disparities and predictors of PCC in ischemic stroke.

Design/Methods

This was a retrospective study that utilized the National Inpatient Sample (NIS) database. Validated International Classification of Diseases (ICD) codes for ischemic stroke were used to identify hospitalizations. The primary outcome was receipt of PCC. Multivariable models were constructed to adjust for relevant characteristics.

Results There were an estimated 4,350,924 weighted hospitalizations, out of which 253,555 received PCC (58.7% were female). Black and Hispanic individuals were less likely to receive PCC than White individuals. Lower income quartiles, urban teaching facilities, Medicaid, and the South were all factors with lower odds of PCC receipt. Clinical variables predicting higher odds of PCC included cerebral edema, hemorrhage, higher NIH stroke scale, sepsis, and neoplastic conditions. Thrombolysis and thrombectomy carried lower odds of PCC receipt.

Conclusions This study uncovered sex- and race/ethnicity-based disparities relating to the use of PCC in ischemic stroke. Additionally, multiple clinical variables were found to be significantly associated with receipt of PCC in ischemic stroke. These data can be valuable to physicians, palliative care specialists, healthcare administrators and policymakers to address these disparities.

Authors/Disclosures
Muhammad Roshan Asghar, MBBS (Creighton University) PRESENTER	Dr. Asghar has nothing to disclose.
Ali M. Al-Salahat, MBBS (Creighton University - Neurology Program)	Dr. Al-Salahat has nothing to disclose.
Alexander Hall, MS	Mr. Hall has nothing to disclose.
Saif S. Bawaneh, MD (Mayo Clinic)	Dr. Bawaneh has nothing to disclose.
Himanshu Verma, MBBS (Creighton University School of Medicine)	Dr. Verma has nothing to disclose.
Nasrin Rahimian, MD	Dr. Rahimian has nothing to disclose.
Jagkirat Singh, MBBS (CHI Health)	Dr. Singh has nothing to disclose.
Rohan Sharma, MD	Dr. Sharma has nothing to disclose.

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