Jamie Yao1, Kaushik Ghosh2, Marcelo C Perraillon3, David M Cutler4,2, Margaret C Fang5. 1. Department of Medicine, University of California, Los Angeles, Los Angeles, CA. 2. National Bureau of Economic Research, Cambridge, MA. 3. Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO. 4. Department of Economics, Harvard University. 5. Division of Hospital Medicine, the University of California, San Francisco, San Francisco, CA.
Abstract
PURPOSE: The main purpose of this study was to determine whether there were temporal differences in the rates of first stroke hospitalizations and 30-day mortality after stroke between black and white Medicare enrollees. METHODS: We used a 20% sample of Medicare beneficiaries aged 65 years or older and described the annual rate of first hospitalization for ischemic and hemorrhagic strokes from years 1988 to 2013, as well as 30-day mortality after stroke hospitalization. We used linear tests of trend to determine whether stroke rates changed over time, and tested the interaction term between race and year to determine whether trends differed by race. RESULTS: We identified 1,009,057 incident hospitalizations for ischemic strokes and 147,817 for hemorrhagic strokes. Annual stroke hospitalizations decreased significantly over time for both blacks and whites, and in both stroke subtypes (P-values for all trend <0.001). Reductions in stroke rates were comparable between blacks and whites: among men, the odds ratio for the interaction term for race by year was 1.008 [95% confidence interval (CI), 1.004-1.012] for ischemic and 1.002 (95% CI, 0.999-1.004) for hemorrhagic; for women, it was 1.000 (95% CI, 0.997-1.004) for ischemic and 1.003 (95% CI, 1.001-1.006) for hemorrhagic. Both black men and women experienced greater improvements over time in terms of 30-day mortality after strokes. CONCLUSIONS: Rates of incident hospitalizations for ischemic and hemorrhagic strokes fell significantly over a 25-year period for both black and white Medicare enrollees. Black men and women experienced greater improvements in 30-day mortality after both ischemic and hemorrhagic stroke.
PURPOSE: The main purpose of this study was to determine whether there were temporal differences in the rates of first stroke hospitalizations and 30-day mortality after stroke between black and white Medicare enrollees. METHODS: We used a 20% sample of Medicare beneficiaries aged 65 years or older and described the annual rate of first hospitalization for ischemic and hemorrhagic strokes from years 1988 to 2013, as well as 30-day mortality after stroke hospitalization. We used linear tests of trend to determine whether stroke rates changed over time, and tested the interaction term between race and year to determine whether trends differed by race. RESULTS: We identified 1,009,057 incident hospitalizations for ischemic strokes and 147,817 for hemorrhagic strokes. Annual stroke hospitalizations decreased significantly over time for both blacks and whites, and in both stroke subtypes (P-values for all trend <0.001). Reductions in stroke rates were comparable between blacks and whites: among men, the odds ratio for the interaction term for race by year was 1.008 [95% confidence interval (CI), 1.004-1.012] for ischemic and 1.002 (95% CI, 0.999-1.004) for hemorrhagic; for women, it was 1.000 (95% CI, 0.997-1.004) for ischemic and 1.003 (95% CI, 1.001-1.006) for hemorrhagic. Both black men and women experienced greater improvements over time in terms of 30-day mortality after strokes. CONCLUSIONS: Rates of incident hospitalizations for ischemic and hemorrhagic strokes fell significantly over a 25-year period for both black and white Medicare enrollees. Black men and women experienced greater improvements in 30-day mortality after both ischemic and hemorrhagic stroke.
Authors: Margaret C Fang; Marcelo Coca Perraillon; Kaushik Ghosh; David M Cutler; Allison B Rosen Journal: Am J Med Date: 2014-03-25 Impact factor: 4.965
Authors: Silvia Koton; Andrea L C Schneider; Wayne D Rosamond; Eyal Shahar; Yingying Sang; Rebecca F Gottesman; Josef Coresh Journal: JAMA Date: 2014-07-16 Impact factor: 56.272
Authors: A Mosterd; R B D'Agostino; H Silbershatz; P A Sytkowski; W B Kannel; D E Grobbee; D Levy Journal: N Engl J Med Date: 1999-04-22 Impact factor: 91.245
Authors: Sarah Song; Gregg C Fonarow; DaiWai M Olson; Li Liang; Phillip J Schulte; Adrian F Hernandez; Eric D Peterson; Mathew J Reeves; Eric E Smith; Lee H Schwamm; Jeffrey L Saver Journal: Stroke Date: 2016-04-14 Impact factor: 7.914
Authors: Hammad Ghanchi; Tye Patchana; James Wiginton; Jonathan D Browne; Ai Ohno; Ronit Farahmandian; Jason Duong; Vladimir Cortez; Dan E Miulli Journal: Cureus Date: 2020-09-10
Authors: Xin Tong; Linda Schieb; Mary G George; Cathleen Gillespie; Robert K Merritt; Quanhe Yang Journal: Prev Chronic Dis Date: 2021-02-18 Impact factor: 2.830
Authors: Gurbey Ocak; Rianne Boenink; Marlies Noordzij; Willem Jan W Bos; Bjorn E Vikse; Aleix Cases; Julia Kerschbaum; Jaakko Helve; Maurizio Nordio; Mustafa Arici; Lucile Mercadal; Christoph Wanner; Runolfur Palsson; Kristine Hommel; Johan De Meester; Myrto Kostopoulou; Rafael Santamaria; Emilio Rodrigo; Helena Rydell; Samira Bell; Ziad A Massy; Kitty J Jager; Anneke Kramer Journal: JAMA Netw Open Date: 2022-04-01