Non-English primary language and disparities in stroke outcomes after mechanical thrombectomy: a single institution study.

Abstract

Background: Delays in acute treatment of ischemic stroke have been associated with worse outcomes. While having a non-English primary language has not been shown to delay receiving thrombolytic therapy, we assessed whether non-English primary language was associated with worse functional outcomes in patients receiving mechanical thrombectomy (MT).

Method: This is a retrospective study of our MT database from two comprehensive stroke centers from January 2016 to May 2021. Primary endpoint was discharge modified Rankin Scale (mRS) 0-2. Differences between English primary language (EPL) and non-English primary language (nEPL) groups were evaluated using an analysis of variance (ANOVA), Kruskal-Wallis and chi square test. Multivariable logistic regression was used to evaluate EPL vs. nEPL patients using data driven models determined by stepwise selection approach.

Result: We identified 276 patients receiving MT with 83% EPL and 17% nEPL patients. nEPL patients had higher mean hemoglobin A1c, were less likely to have insurance, and more likely to have symptomatic intracranial hemorrhage compared to EPL patients (Table). We observed a longer median ED arrival to groin puncture time in the nEPL group. No differences were observed in discharge or mRS 0-2 in the univariate or multivariable logistic regression.

Discussion: Despite finding longer ED length of stay among nEPL patients, there was no difference between nEPL and EPL in good functional outcome rates in patients treated with MT.