Faculty, Staff and Student Publications

Language

English

Publication Date

8-1-2024

Journal

Journal of Stroke and Cerebrovascular Diseasess

DOI

10.1016/j.jstrokecerebrovasdis.2024.107787

PMID

38806108

Abstract

Background: Cognitive impairment (CI) and stroke are diseases with significant disparities in race and geography. Post stroke cognitive impairment (PSCI) can be as high as 15-70 % but few studies have utilized large administrative or electronic health records (EHR) to evaluate trends in PSCI. We utilized an EHR database to evaluate for disparities in PSCI in a large sample of patients after first recorded stroke to evaluate for disparities in race.

Methods: This is a retrospective cohort analysis of Cerner Health Facts® EHR database, which is comprised of EHR data from hundreds of hospitals/clinics in the US from 2009-2018. We evaluated patients ≥40 years of age with a first time ischemic stroke (IS) diagnosis for PSCI using ICD9/10 codes for both conditions. Patients with first stroke in the Cerner database and no pre-existing cognitive impairment were included, we compared hazard ratios for developing PSCI for patient characteristics RESULTS: A total of 150,142 IS patients with follow-up data and no pre-existing evidence of CI were evaluated. Traditional risk factors of age, female sex, kidney injury, hypertension, and hyperlipidemia were associated with PSCI. Only African American stroke survivors had a higher probability of developing PSCI compared to White survivors (HR 1.347, 95 % CI (1.270, 1.428)) and this difference was most prominent in the South. Among those to develop PSCI, median time to documentation was 1.8 years in African American survivors.

Conclusion: In a large national database, African American stroke survivors had a higher probability of PSCI five years after stroke than White survivors.

Keywords

Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Black or African American, Cognition, Cognitive Dysfunction, Databases, Factual, Electronic Health Records, Health Status Disparities, Incidence, Ischemic Stroke, Prognosis, Race Factors, Retrospective Studies, Risk Assessment, Risk Factors, Stroke, Time Factors, United States, White, Administrative database, Cognitive impairment, Electronic health record, Ischemic stroke

Published Open-Access

yes

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.