Abstract Details

Title Elevated Stroke Morbidity and Mortality in Asian Americans: an Exploratory Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 5-021

Objective To explore drivers underlying morbidity and mortality among Asian patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH).

Background Existing literature presents conflicting evidence on stroke-related morbidity and mortality among Asian American patients.

Design/Methods Retrospective study of AIS and ICH patients aged ≥18 years and discharged from the neurology department at three comprehensive stroke centers from Jan 1 2023- Dec 31 2024. Demographic factors, social determinants of health including pre-hospital health care utilization, clinical admission factors, and discharge data were abstracted from the chart. Chi-squared and one-way ANOVA analyses were performed.

Results We identified 9352 patients with acute stroke (mean age 56.9±22.5 years and 49% female, 10% Asian). Median household income by zip code was higher for Asian patients ($104,236 [IQR=63,564]) than non-Asian patients ($73,927 [IQR=55,845]). Initial NIHSS was higher in Asian patients (7.9±8.8) compared to non-Asian patients (5.6±7.3) (p<.001). Asian patients had a higher rate of in-hospital mortality (4.9% vs. 3%, p=0.009) as well as higher discharge mRS (2.6±1.9 vs. 2.4±1.8, p=.05). Among Asian patients, discharge mRS was higher in non-English proficient patients (2.9±1.8) compared to English-proficient patients (2.0±1.8) (p<.001). Among two largest Asian subgroups, Chinese (n=431) and Indian (n=71), Chinese patients were more likely to have ICH (p<.001) and had a higher discharge mRS (2.9±1.8) than Indian patients (2.0±1.9) (p<.001). Chinese and Indian patients had similar rates of primary care doctor visits (p =.251) and smoking (p =.535).

Conclusions Our data show that Asian patients had higher initial NIHSS scores, worse discharge mRS, and greater in-hospital mortality, despite residing in higher-income zip codes. Chinese patients, in particular, had worse overall outcomes evidenced by higher rates of mortality, ICH, and elevated discharge mRS compared to other Asian subgroups. This occurred despite similar rates of smoking and primary care engagement.

Authors/Disclosures
Catherine W. Imossi, MD PRESENTER	Dr. Imossi has nothing to disclose.
Benjamin M. Jadow, MD	Mr. Jadow has nothing to disclose.
Christopher Chornay, MD (NYULH)	Mr. Chornay has nothing to disclose.
Sungita Kumar, MD (Columbia University)	Dr. Kumar has nothing to disclose.
Esther Kim	Ms. Kim has nothing to disclose.
Jose L. Torres, MD (NYU)	Dr. Torres has nothing to disclose.
Koto Ishida, MD, FAAN (NYU)	Dr. Ishida has received publishing royalties from a publication relating to health care.
Brandon Giglio, MD (NYU Langone Medical Center)	Dr. Giglio has nothing to disclose.
Rajanandini Muralidharan, MD, FAAN (Winthrop Neuroscience)	Dr. Muralidharan has nothing to disclose.
Ariane Lewis, MD, FAAN (NYU Langone Medical Center)	Dr. Lewis has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Seminars in Neurology. Dr. Lewis 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 Journal of Clinical Neuroscience.
Myrna Cardiel, MD	Dr. Cardiel has nothing to disclose.
Jeana Gratch, MBA	Mrs. Gratch has nothing to disclose.
Steven Galetta, MD, FAAN (NYU Langone Medical Center)	Dr. Galetta has nothing to disclose.
Kara R. Melmed, MD (NYU Langone Neurology Associates)	Dr. Melmed has nothing to disclose.

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