Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke

医学 冲程(发动机) 优势比 逻辑回归 人口 内科学 物理疗法 急诊医学 机械工程 环境卫生 工程类
作者
Sarah Song,Li Liang,Gregg C. Fonarow,Eric E. Smith,Deepak L. Bhatt,Roland A. Matsouaka,Ying Xian,Lee H. Schwamm,Jeffrey L. Saver
出处
期刊:JAMA Neurology [American Medical Association]
卷期号:76 (4): 430-430 被引量:56
标识
DOI:10.1001/jamaneurol.2018.4410
摘要

Although overall stroke incidence and mortality in the United States is improving, little is known about the characteristics and clinical outcomes of acute ischemic stroke in Asian American individuals.To compare the characteristics, care, and outcomes of Asian American and white patients with acute ischemic stroke.Retrospective analysis of Asian American and white patients admitted with a primary diagnosis of acute ischemic stroke to hospitals participating in the Get With The Guidelines-Stroke (GWTG-Stroke) program between April 1, 2004, and July 31, 2016. The GWTG-Stroke database is a prospectively collected stroke quality improvement registry sponsored by the American Heart Association/American Stroke Association.Multivariable logistic regression models assessed the association of Asian American race/ethnicity, clinical outcomes, and quality measures.The study population of 1 772 299 patients (mean [SD] age, 72.4 [14.2] years; 51.3% female) consisted of 64 337 Asian American patients (3.6%) and 1 707 962 white patients (96.4%) admitted to 2171 GWTG-Stroke hospitals with acute ischemic stroke. After adjustment for patient and hospital variables, Asian American patients were seen with greater stroke severity compared with white patients (National Institutes of Health Stroke Scale [NIHSS] score ≥16) (odds ratio [OR], 1.35; 95% CI, 1.30-1.40; P < .001), manifested higher in-hospital mortality (OR, 1.14; 95% CI, 1.09-1.19; P < .001), had longer length of stay (OR, 1.17; 95% CI, 1.14-1.20; P < .001), and were less likely to ambulate independently at discharge (OR, 0.84; 95% CI, 0.79-0.90; P < .001). Although Asian American patients had fewer intravenous tissue plasminogen activator (IV tPA) administrations than white patients (OR, 0.95; 95% CI, 0.91-0.98; P = .003), they had more symptomatic hemorrhage after tPA (OR, 1.36; 95% CI, 1.20-1.55; P < .001) and overall post-tPA complications (OR, 1.31; 95% CI, 1.18-1.46; P < .001). Asian American patients had better quality measure adherence overall than white patients, including rehabilitation (OR, 1.27; 95% CI, 1.18-1.36; P < .001), door to tPA within 60 minutes (OR, 1.14; 95% CI, 1.06-1.22; P < .001), and intensive statin therapy (OR, 1.14; 95% CI, 1.10-1.18; P < .001). After adjustment for stroke severity, Asian American patients had lower in-hospital mortality than white patients (OR, 0.95; 95% CI, 0.91-0.99; P = .008).Asian American patients manifested more severe ischemic strokes, were less likely to receive IV tPA, and had worse functional outcomes than white patients. These findings warrant additional research toward improving clinical outcomes for Asian American patients with acute ischemic stroke.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
田様应助大橙子采纳,获得10
1秒前
1秒前
SYLH应助Echo_1995采纳,获得10
3秒前
吕小布完成签到,获得积分10
4秒前
骑驴追火箭完成签到,获得积分10
6秒前
baomingqiu完成签到 ,获得积分10
6秒前
乐观寻雪完成签到 ,获得积分10
8秒前
量子星尘发布了新的文献求助10
9秒前
复杂勒完成签到,获得积分10
9秒前
10秒前
bird完成签到,获得积分10
11秒前
AaronDP发布了新的文献求助50
12秒前
terryok完成签到,获得积分10
13秒前
Cll完成签到 ,获得积分10
13秒前
聪明的宛菡完成签到,获得积分10
14秒前
CNYDNZB完成签到 ,获得积分10
14秒前
xxj完成签到 ,获得积分10
14秒前
芊芊完成签到 ,获得积分10
15秒前
yar应助bluesky采纳,获得10
15秒前
海人完成签到 ,获得积分10
16秒前
SY15732023811完成签到 ,获得积分10
18秒前
李建勋完成签到,获得积分10
18秒前
科研通AI2S应助一路芬芳采纳,获得10
18秒前
黄花完成签到 ,获得积分10
19秒前
刘珍荣完成签到,获得积分10
20秒前
20秒前
紫金之巅完成签到 ,获得积分10
20秒前
Gang完成签到,获得积分10
21秒前
22秒前
22秒前
23秒前
CYYDNDB完成签到 ,获得积分10
23秒前
粿粿一定行完成签到 ,获得积分10
24秒前
25秒前
战战完成签到,获得积分10
26秒前
xlk2222完成签到,获得积分10
29秒前
笨笨以莲完成签到,获得积分10
29秒前
YHX完成签到,获得积分10
30秒前
沐沐心完成签到 ,获得积分10
31秒前
31秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038184
求助须知:如何正确求助?哪些是违规求助? 3575908
关于积分的说明 11373872
捐赠科研通 3305715
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022