Black patients may have a higher risk of mortality after an ischemic stroke than patients of other races. This is evident from the results presented remotely at the International Stroke Conference March 17-19, 2021.
The study researchers attempted to identify the 10-year mortality outcomes of older stroke patients in the United States by analyzing the race of the patients and their long-term survival.
This study included a total of 744,044 Medicare beneficiaries (mean age, 78.7 years). The majority of the patients were women (54.7%) and whites (85.6%). They were discharged from acute care between 2005 and 2007 with a diagnosis of ischemic stroke.
Patient follow-up continued until 2016. Using inverse probability weighting (IPW), the study researchers rated their racial differences in mortality risk using inverse probability weighting (IPW). They used a logistic regression model to identify a patient’s race based on age, Medicaid eligibility, comorbidities, hospital complications, discharge disposition, length of stay, and Medicare payment. A Cox regression model was used to identify the relationship between race and 10-year mortality.
Among the 744,044 patients discharged with ischemic stroke, the percentage of black patients enrolled (9.9%) was mostly women who were younger. In addition, the study showed that black patients were more prone to comorbidities such as kidney failure, dementia, and diabetes, while white patients were more prone to chronic obstructive pulmonary disease (COPD) and atherosclerosis.
After analyzing the 10-year mortality rate (75.3%) for the entire study population, the study researchers found that black patients had the highest death rate (76.4%), followed by white patients (75.4%) and those of others Races (70.3%)%). Compared to white patients, the risk of death within 10 years after the stroke was increased in black patients (RR = 1.04, 95% CI, 1.03-1.04) and decreased in all other races (RR = 0.92 ; 95% CI, 0.90-0.93)).
Study researchers found a correlation between increased mortality risk and race among stroke survivors. They concluded that “more than 75% of stroke patients died within 10 years” and the risk was “higher for black stroke patients, even after taking socio-demographic factors and index hospitalization factors into account”.
Disclosure: Several authors have stated that they are part of the pharmaceutical industry. For a full list of author details, see the original reference.
Lichtman JH, Leifheit EC, Wang Y, Arakaki A, Goldstein LB. Racial differences in 10-year mortality after ischemic stroke. Presented at: International Stroke Conference; 17th-19th March 2021. Abstract P655.