Background: The growth of telestroke services expanded the reach of acute stroke treatment. However, ethnic disparities in receiving such treatment have not been fully assessed. Materials and Methods: We reviewed prospectively maintained data on patients evaluated through the Medical University of South Carolina telestroke program between January 2016 and November 2018. Outcomes included odds of receiving intravenous recombinant tissue plasminogen activator (tPA), receiving mechanical thrombectomy (MT), and achieving door-to-needle (DTN) time ≤60 and ≤45 min among patients receiving tPA. We used logistic regression to analyze the contribution of race/ethnicity. Results: We included 2,977 patients, of whom 1,093 (36.7%) identified as nonwhite; of these, 1,048 patients (95.9%) identified as black or African American. Significantly more nonwhite patients were seen at a primary stroke center (PSC) (68.4% vs. 52.3% in whites, p < 0.001). However, white patients had significantly higher odds of receiving tPA (odds ratio [OR] 1.47, confidence interval [95% CI] 1.17-1.84). There was no significant difference in receiving MT between races. Among patients receiving tPA, whites had higher odds of DTN ≤45 min (OR 1.76, 1.20-2.57) and ≤60 min (OR 1.87, 95% CI 1.31-2.66). Conclusions: White patients had better odds achieving DTN ≤45 min and DTN ≤60 min if receiving tPA within a telestroke setting, as well as higher odds of receiving tPA, even after adjustment for comorbidities. This was noted despite white patients having less access to PSCs. However, larger scale studies are needed to further study the impact of ethnic disparities.
Background: The growth of telestroke services expanded the reach of acute stroke treatment. However, ethnic disparities in receiving such treatment have not been fully assessed. Materials and Methods: We reviewed prospectively maintained data on patients evaluated through the Medical University of South Carolina telestroke program between January 2016 and November 2018. Outcomes included odds of receiving intravenous recombinant tissue plasminogen activator (tPA), receiving mechanical thrombectomy (MT), and achieving door-to-needle (DTN) time ≤60 and ≤45 min among patients receiving tPA. We used logistic regression to analyze the contribution of race/ethnicity. Results: We included 2,977 patients, of whom 1,093 (36.7%) identified as nonwhite; of these, 1,048 patients (95.9%) identified as black or African American. Significantly more nonwhite patients were seen at a primary stroke center (PSC) (68.4% vs. 52.3% in whites, p < 0.001). However, white patients had significantly higher odds of receiving tPA (odds ratio [OR] 1.47, confidence interval [95% CI] 1.17-1.84). There was no significant difference in receiving MT between races. Among patients receiving tPA, whites had higher odds of DTN ≤45 min (OR 1.76, 1.20-2.57) and ≤60 min (OR 1.87, 95% CI 1.31-2.66). Conclusions: White patients had better odds achieving DTN ≤45 min and DTN ≤60 min if receiving tPA within a telestroke setting, as well as higher odds of receiving tPA, even after adjustment for comorbidities. This was noted despite white patients having less access to PSCs. However, larger scale studies are needed to further study the impact of ethnic disparities.
Authors: Adam de Havenon; Kevin Sheth; Karen C Johnston; Alen Delic; Eric Stulberg; Jennifer Majersik; Mohammad Anadani; Shadi Yaghi; David Tirschwell; John Ney Journal: Neurology Date: 2021-10-14 Impact factor: 9.910
Authors: Imama A Naqvi; Ying Kuen Cheung; Kevin Strobino; Hanlin Li; Sarah E Tom; Zehra Husaini; Olajide A Williams; Randolph S Marshall; Adriana Arcia; Ian M Kronish; Mitchell S V Elkind Journal: Pilot Feasibility Stud Date: 2022-04-11
Authors: Amie W Hsia; Marie L Luby; Richard Leigh; John K Lynch; Zurab Nadareishvili; Richard T Benson; Chandni Kalaria; Shannon P Burton; Larry Latour Journal: Neurology Date: 2021-01-20 Impact factor: 9.910
Authors: Sami Al Kasab; Eyad Almallouhi; Ali Alawieh; Pascal Jabbour; Ahmad Sweid; Robert M Starke; Vasu Saini; Stacey Q Wolfe; Kyle M Fargen; Adam S Arthur; Nitin Goyal; Abhi Pandhi; Ilko Maier; Jonathan A Grossberg; Brian M Howard; Stavropoula I Tjoumakaris; Ansaar Rai; Min S Park; Justin R Mascitelli; Marios N Psychogios; Alejandro M Spiotta Journal: J Neurointerv Surg Date: 2021-01-06 Impact factor: 5.836