Changes Over Time in Short-Term Stroke Outcomes by Race-Ethnicity.

IF 7.7 1区医学 Q1 CLINICAL NEUROLOGY Neurology Pub Date : 2024-12-10 Epub Date: 2024-11-12 DOI:10.1212/WNL.0000000000210033

Lynda D Lisabeth, Devin L Brown, Darin B Zahuranec, Erin Case, Madeline Kwicklis, Melinda A Smith, Lewis B Morgenstern

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Abstract

Objectives: The objective of this study was to quantify trends (2008-2019) in stroke outcomes by race-ethnicity.

Methods: Patients with ischemic stroke from a population-based study were interviewed at 90 days to assess outcomes. Linear regression with multiple imputation and inverse probability weighting was used to model trends.

Results: The median age was 66 years (n = 1,449); 61% were Mexican American (MA). QOL remained stable with no race-ethnic difference in trends (p for time*race-ethnicity interaction = 0.81). Neurologic outcomes improved for MA (p < 0.01) but not non-Hispanic White (NHW) persons with stroke (p = 0.23) with no race-ethnic difference in trends (p for interaction = 0.23). For functional outcomes, trends were stable and then improved in MA persons with stroke (p for interaction = 0.01), whereas trends were stable in NHW persons with stroke (p = 0.52). For cognitive outcomes, there was little change in NHW persons with stroke (p = 0.50); in MA persons with stroke, there was improvement followed by decline and then improvement (p = 0.03). No race-ethnic differences in trends in functional (p for interaction = 0.51) or cognitive (p for interaction = 0.21) outcomes were noted.

Discussion: Outcome improvements were noted in MA but not NHW persons with stroke; race-ethnic differences were not present in 2019. Understanding factors contributing to favorable trends in MA persons may be informative for improving outcomes in all persons.

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不同种族的中风短期疗效随时间的变化。

研究目的本研究旨在量化（2008-2019 年）不同种族-族裔的中风预后趋势：方法：对一项基于人口的研究中的缺血性中风患者进行 90 天访谈，以评估其预后。采用多重归因和反概率加权的线性回归建立趋势模型：中位年龄为 66 岁（n = 1,449）；61% 为墨西哥裔美国人（MA）。QOL 保持稳定，无种族-族裔趋势差异（时间*种族-族裔交互作用 p = 0.81）。墨西哥裔美国人（P < 0.01）的神经功能结果有所改善，但非西班牙裔白人（NHW）中风患者的神经功能结果没有改善（P = 0.23），趋势上没有种族-人种差异（交互作用的 P = 0.23）。在功能结果方面，马萨诸塞州脑卒中患者的趋势是先稳定后改善（交互作用 p = 0.01），而非西班牙裔白人脑卒中患者的趋势是稳定的（p = 0.52）。在认知能力方面，北荷兰人中风患者几乎没有变化（p = 0.50）；而马萨诸塞州的中风患者则是先改善后下降，然后再改善（p = 0.03）。在功能性（交互作用 p = 0.51）或认知性（交互作用 p = 0.21）结果的趋势方面，未发现种族-民族差异：讨论：马萨诸塞州脑卒中患者的预后有所改善，而非新罕布什尔州脑卒中患者。了解导致马萨诸塞州患者出现有利趋势的因素可能有助于改善所有患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology 医学-临床神经学

CiteScore

12.20

自引率

4.00%

发文量

1973

审稿时长

2-3 weeks

期刊介绍： Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology. As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content. Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.