What useless research, tell our stroke leadership to solve stroke instead of telling us it exists and we won't do a damn thing about it.
Send me hate mail on this:
oc1dean@gmail.com. I'll print your complete statement with your name and my
response in my blog. Or are you afraid to engage with my stroke-addled
mind? I need an explanation of your thought processes on stroke research and why you're not solving stroke.
Temporal Trends and Racial Disparities in Long-Term Survival After Stroke
Abstract
Background and Objectives
Few
studies have examined trends and disparities in long-term outcome after
stroke in a representative US population. We used a population-based
stroke study in the Greater Cincinnati Northern Kentucky region to
examine trends and racial disparities in poststroke 5-year mortality.
Methods
All
patients with acute ischemic strokes (AISs) and intracerebral
hemorrhages (ICHs) among residents ≥20 years old were ascertained using
ICD codes and physician-adjudicated using a consistent case definition
during 5 periods: July 1993–June 1994 and calendar years 1999, 2005,
2010, and 2015. Race was obtained from the medical record; only those
identified as White or Black were included. Premorbid functional status
was assessed using the modified Rankin Scale, with a score of 0–1 being
considered “good.” Mortality was assessed with the National Death Index.
Trends and racial disparities for each subtype were analyzed with
logistic regression.
Results
We
identified 8,428 AIS cases (19.3% Black, 56.3% female, median age 72)
and 1,501 ICH cases (23.5% Black, 54.8% female, median age 72). Among
patients with AIS, 5-year mortality improved after adjustment for age,
race, and sex (53% in 1993/94 to 48.3% in 2015, overall effect of study
year p = 0.009). The absolute decline in 5-year mortality in
patients with AIS was larger than what would be expected in the general
population (5.1% vs 2.8%). Black individuals were at a higher risk of
death after AIS (odds ratio [OR] 1.23, 95% CI 1.08–1.39) even after
adjustment for age and sex, and this effect was consistent across study
years. When premorbid functional status and comorbidities were included
in the model, the primary effect of Black race was attenuated but race
interacted with sex and premorbid functional status. Among male patients
with a good baseline functional status, Black race remained associated
with 5-year mortality (OR 1.4, 95% CI 1.1–1.7, p = 0.002). There
were no changes in 5-year mortality after ICH over time (64.4% in
1993/94 to 69.2% in 2015, overall effect of study year p = 0.32).
Discussion
Long-term
survival improved after AIS but not after ICH. Black individuals,
particularly Black male patients with good premorbid function, have a
higher mortality after AIS, and this disparity did not change over time.
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