Underutilization of Endovascular Therapy in Black Patients With Ischemic Stroke: An Analysis of State and Nationwide Cohorts

Authors

Youngran Kim
Anjail Sharrief
Min Ji Kwak
Swapnil Khose
Rania Abdelkhaleq
Sergio Salazar-Marioni
Guo-Qiang Zhang
Sunil A Sheth

Publication Date

3-1-2022

Journal

Stroke

Abstract

BACKGROUND AND PURPOSE: Endovascular therapy (EVT) is a very effective treatment but relies on specialized capabilities that are not available in every hospital where acute ischemic stroke is treated. Here, we assess whether access to and utilization of this therapy has extended uniformly across racial and ethnic groups.

METHODS: We conducted a retrospective, population-based study using the 2019 Texas Inpatient Public Use Data File. Acute ischemic stroke cases and EVT use were identified using the

RESULTS: Among 40 814 acute ischemic stroke cases in Texas in 2019, 54% were White, 17% Black, and 21% Hispanic. Black patients had similar admissions to EVT-performing hospitals and greater admissions to comprehensive stroke centers (CSCs) compared with White patients (EVT 62% versus 62%,

CONCLUSIONS: We found no evidence of disparity in presentation to EVT-performing hospitals or CSCs; however, lower rates of EVT were observed in Black patients.

Keywords

Adolescent, Adult, Black or African American, Aged, Aged, 80 and over, Endovascular Procedures, Female, Humans, Ischemic Stroke, Male, Middle Aged, Retrospective Studies, Texas, Tissue Plasminogen Activator