
Background and Purpose: Ethnic disparities in stroke are well described, with a higher incidence of disability and increased mortality in Blacks versus Whites. We sought to compare the clinical outcomes between those ethnic groups after stroke endovascular therapy (ET).
Methods: We performed a retrospective review of the prospectively acquired Grady Endovascular Stroke Outcomes Registry between September 1, 2010 and September 30, 2015. Patients were dichotomized into two groups – Caucasians and African-Americans – and matched for age, pretreatment glucose level, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Baseline characteristics as well as procedural and outcome parameters were compared.
Results: Out of the 830 patients treated with ET, 308 pairs of patients (
n = 616) underwent primary analysis. African-Americans were younger (
p #x3c; 0.01), had a higher prevalence of hypertension (
p #x3c; 0.01) and diabetes (
p = 0.04), and had higher Alberta Stroke Program Early CT Score values (
p = 0.03) and shorter times to treatment (
p = 0.01). Blacks more frequently had Medicaid coverage and less private insurance (29.6 vs. 11.4% and 41.5 vs. 60.3%, respectively,
p #x3c; 0.01). The remaining baseline characteristics, including baseline NIHSS score and CT perfusion-derived ischemic core volumes, were well balanced. There were no differences in the overall distribution of 90-day modified Rankin scale scores (
p = 0.28), rates of successful reperfusion (84.7 vs. 85.7%,
p = 0.91), good outcomes (49.1 vs. 44%,
p = 0.24), or parenchymal hematomas (6.5 vs. 6.8%,
p = 1.00). Blacks had lower 90-day mortality rates (18 vs. 24.6%,
p = 0.04) in univariate analysis, which persisted as a nonsignificant trend after adjustment for potential confounders (OR 0.52, 95% CI 0.26–1.03,
p = 0.06).
Conclusions: Despite unique baseline characteristics, African-Americans treated with ET for large vessel occlusion strokes have similar outcomes as Caucasians. Greater availability of ET may diminish the ethnic/racial disparities in stroke outcomes.
Intervent Neurol 2018;7:389–398
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