BACKGROUND: Since the introduction of recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke, rt-PA rate and number of stroke centers have increased. Despite this, studies have shown racial and ethnic disparities in stroke care especially in Black and Hispanic populations. What factors are related to the administration of rt-PA within the Hispanic population has to date been unclear. METHODS: We performed a retrospective review of IRB approved, prospectively collected data from the UC San Diego Stroke Registry from 7/2004-7/2016. Patients were included based on the primary diagnosis of Transient Ischemic Attack or Ischemic Stroke. Hispanic vs non-Hispanic patients were compared to assess for overall rt-PA treatment rates and process of care intervals. For the Hispanic cohort itself, demographics and NIHSS scores were assessed to determine why some Hispanics received rt-PA while others were not. RESULTS: Overall, 1489 patients (300 Hispanic vs. 1189 non-Hispanic) were included. Comparing Hispanics to non-Hispanics, there was no difference in rt-PA rate (35.3% vs. 33.1%; p=0.49). In rt-PA treated patients, "onset to arrival" interval was higher in Hispanics (1.03 vs. 0.88 hours; p=0.04), while the "arrival to treatment" interval was not different (1.13 vs. 1.02 hours; p=0.07). When looking at Hispanic patients only, there was no difference in baseline characteristics except for initial NIHSS in treated vs. non-treated patients (13.27 vs. 7.24; p<.001). CONCLUSION: Our analyses sought to determine the factors important to administration of rt-PA to Hispanic patients. These findings highlight the need for strategies to improve recognition and presentation pathways for Hispanics.
BACKGROUND: Since the introduction of recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke, rt-PA rate and number of stroke centers have increased. Despite this, studies have shown racial and ethnic disparities in stroke care especially in Black and Hispanic populations. What factors are related to the administration of rt-PA within the Hispanic population has to date been unclear. METHODS: We performed a retrospective review of IRB approved, prospectively collected data from the UC San Diego Stroke Registry from 7/2004-7/2016. Patients were included based on the primary diagnosis of Transient Ischemic Attack or Ischemic Stroke. Hispanic vs non-Hispanic patients were compared to assess for overall rt-PA treatment rates and process of care intervals. For the Hispanic cohort itself, demographics and NIHSS scores were assessed to determine why some Hispanics received rt-PA while others were not. RESULTS: Overall, 1489 patients (300 Hispanic vs. 1189 non-Hispanic) were included. Comparing Hispanics to non-Hispanics, there was no difference in rt-PA rate (35.3% vs. 33.1%; p=0.49). In rt-PA treated patients, "onset to arrival" interval was higher in Hispanics (1.03 vs. 0.88 hours; p=0.04), while the "arrival to treatment" interval was not different (1.13 vs. 1.02 hours; p=0.07). When looking at Hispanic patients only, there was no difference in baseline characteristics except for initial NIHSS in treated vs. non-treated patients (13.27 vs. 7.24; p<.001). CONCLUSION: Our analyses sought to determine the factors important to administration of rt-PA to Hispanic patients. These findings highlight the need for strategies to improve recognition and presentation pathways for Hispanics.
Authors: Amie W Hsia; Dorothy F Edwards; Lewis B Morgenstern; Jeffrey J Wing; Nina C Brown; Regina Coles; Sarah Loftin; Andrea Wein; Sara S Koslosky; Sabiha Fatima; Brisa N Sánchez; Ali Fokar; M Chris Gibbons; Nawar Shara; Annapurni Jayam-Trouth; Chelsea S Kidwell Journal: Stroke Date: 2011-06-30 Impact factor: 7.914
Authors: Salvador Cruz-Flores; Alejandro Rabinstein; Jose Biller; Mitchell S V Elkind; Patrick Griffith; Philip B Gorelick; George Howard; Enrique C Leira; Lewis B Morgenstern; Bruce Ovbiagele; Eric Peterson; Wayne Rosamond; Brian Trimble; Amy L Valderrama Journal: Stroke Date: 2011-05-26 Impact factor: 7.914
Authors: Lee H Schwamm; Mathew J Reeves; Wenqin Pan; Eric E Smith; Michael R Frankel; DaiWai Olson; Xin Zhao; Eric Peterson; Gregg C Fonarow Journal: Circulation Date: 2010-03-22 Impact factor: 29.690
Authors: Lee H Schwamm; Syed F Ali; Mathew J Reeves; Eric E Smith; Jeffrey L Saver; Steven Messe; Deepak L Bhatt; Maria V Grau-Sepulveda; Eric D Peterson; Gregg C Fonarow Journal: Circ Cardiovasc Qual Outcomes Date: 2013-09-01
Authors: Amelia K Boehme; James E Siegler; Michael T Mullen; Karen C Albright; Michael J Lyerly; Dominique J Monlezun; Erica M Jones; Rikki Tanner; Nicole R Gonzales; T Mark Beasley; James C Grotta; Sean I Savitz; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2014-01-25 Impact factor: 2.136
Authors: Dawn Kleindorfer; Christopher J Lindsell; Lawrence Brass; Walter Koroshetz; Joseph P Broderick Journal: Stroke Date: 2008-01-31 Impact factor: 7.914
Authors: William P Neil; Rema Raman; Thomas M Hemmen; Karin Ernstrom; Brett C Meyer; Dawn M Meyer; Bruce Ovbiagele Journal: Ethn Dis Date: 2015 Impact factor: 2.006
Authors: Hugo J Aparicio; Brendan G Carr; Scott E Kasner; Michael J Kallan; Karen C Albright; Dawn O Kleindorfer; Michael T Mullen Journal: J Am Heart Assoc Date: 2015-10-14 Impact factor: 5.501