Ying Xian|Robert G. Holloway|Katia Noyes|Manish N. Shah|Bruce Friedman
Racial Differences in Mortality Among Patients With Acute Ischemic Stroke
Clinical Research Institute|University of Rochester|Clinical Research Institute|University of Rochester|Clinical Research Institute|University of Rochester|Clinical Research Institute|University of Rochester|Clinical Research Institute|University of Rochester
background black patients commonly believed higher stroke mortality however several recent studies reported better survival black patients stroke objective examine racial differences stroke mortality explore potential reasons differences design observational cohort study setting 164 hospitals new york participants 5319 black 18 340 white patients aged 18 years older hospitalized acute ischemic stroke january 2005 december 2006 measurements influence race mortality examined using propensity score analysis secondary outcomes selected aspects endoflife treatment use tissue plasminogen activator hospital spending length stay patients followed mortality 1 year admission results overall inhospital mortality lower black patients white patients 50 vs 74 p 0001 allcause mortality 30 days 61 vs 114 p 0001 1 year 165 vs 244 p 0001 propensity score adjustment black race independently associated lower inhospital mortality odds ratio 077 95 ci 061 098 allcause mortality 1 year 086 ci 077 096 adjusted hazard ratio 087 ci 079 096 adjustment probability dying hospital black patients stroke likely receive lifesustaining interventions 122 ci 109 138 less likely discharged hospice 025 ci 014 046 limitations study used hospital administrative data lacked stroke severity measure study design precluded determination causality conclusion among patients acute ischemic stroke black patients lower mortality white patients could result differences receipt lifesustaining interventions endoflife care primary funding source american heart association founders affiliate