Ethnic Disparities in Outcomes During the Year Following Ischemic Stroke

Ischemic stroke incidence has long been known to vary among ethnic groups. But whether there are ethnic disparities in the patterns of recovery following ischemic stroke is less well understood. To address this issue, investigators conducted a population-based, longitudinal study that compared outcomes after a first ischemic stroke between 807 Mexican American (MA) patients and 525 non-Hispanic white (NHW) patients in a biethnic community in southern Texas. The study assessed outcomes at 3, 6, and 12 months in several domains, including functional outcome, quality of life, neurologic status (measured by the NIH Stroke Scale), and cognitive outcomes (using a modified Mini-Mental Status Examination).

MA patients were younger than NHW patients (median 65 vs. 70 years), were less likely to have attained a high school or higher level of education (58% vs. 92%), and were more likely to be uninsured (17% vs. 9%). There was no difference in the comorbidity index and no statistical difference in alteplase use for the index stroke. In both ethnic groups, outcomes improved between 3 and 6 months. However, MA patients had worse outcomes compared with NHW patients at all time points, with the exception of outcomes measured by the NIH Stroke Scale.