Study Investigates Whether Long-term Outcomes of Acute Ischemic Stroke (AIS) Vary By Race/Ethnicity.


Feng (Johnson) Qian, assistant professor of Health Policy, Management and Behavior at the University at Albany School of Public Health was invited by the American Heart Association Get With The Guidelines (GWTG) Executive Committee to give an oral presentation of his research study abstract on “Racial and Ethnic Differences in Outcomes in Older Patients with Acute Ischemic Stroke” at the 2013 American Heart Association Quality of Care and Outcome Research (QCOR) conference. Simultaneously, the study has been accepted for publication in Circulation: Cardiovascular Quality and Outcomes (IF: 4.91). Qian was also selected for a QCOR early investigator award as one of five finalists awarded a $1000 travel stipend.

Qian’s study investigated whether long-term outcomes of acute ischemic stroke (AIS) vary by race/ethnicity.  Using the American Heart Association Get With the Guidelines (GWTG)-Stroke registry linked with Medicare claims dataset, the study team examined whether 30-day and one year outcomes differed by race/ethnicity among older patients with AIS.  Racial and ethnic disparities in stroke care remain a major public health challenge, and the burden of stroke has been consistently reported to be higher in racial and ethnic minority groups.  However, little is known as to whether there are racial or ethnic differences in long-term acute ischemic stroke outcomes.  Furthermore, Asian American stroke patients had not been studied before.

The study team studied over 200,900 AIS patients 65 years and older  from 926 U.S. centers participating in the GWTG-Stroke program between April 2003 and December 2008.  The study found that among older patients with acute ischemic stroke, there were significant differences in 30-day and 1-year outcomes by race/ethnicity, even after adjustment for stroke severity, other prognostic variables, and hospital characteristics.  Older white patients with AIS had the highest 30-day mortality rates of any race/ethnicity group.  Compared with older white patients with AIS, black and Hispanic patients were more likely to be readmitted to hospitals within one year, even after risk adjustment, and had comparable risk for one year mortality.  And compared with other race/ethnicity groups, Asian American AIS patients had fewer comorbid conditions, higher median household income, and lower median body mass index.  Asian American  patients received similar or even better evidence-based stroke care compared with whites and had the lowest risk-adjusted odds of one year mortality.