TY - JOUR
T1 - Sex and race-ethnic disparities in door-to-ct time in acute ischemic stroke
T2 - The florida stroke registry
AU - Florida Stroke Registry
AU - Polineni, Sai P.
AU - Perez, Enmanuel J.
AU - Wang, Kefeng
AU - Gutierrez, Carolina M.
AU - Walker, Jeffrey
AU - Foster, Dianne
AU - Dong, Chuanhui
AU - Asdaghi, Negar
AU - Romano, Jose G.
AU - Sacco, Ralph L.
AU - Rundek, Tatjana
N1 - Funding Information:
Dr Romano receives salary support to the Department of Neurology at the University of Miami from the Florida Department of Health for work on the Florida Stroke Registry. Dr Romano is a principal investigator of the Transition of Care Stroke Disparity Study (National Institutes of Health/ National Institute of Mental Health 1R01MD012467), the Mechanisms of Early Recurrence in Intracranial Atherosclerotic Disease study (1R01NS084288), the Florida Regional Coordinating Center for StrokeNet (1U24NS107267), and receives salary support from Genentech for his role as principal investigator of the MaRISS (Mild and Rapidly Improving Stroke Study). Dr Sacco is a recipient and principal investigator of the Stroke Prevention and Intervention Research Program cooperative grant (National Institutes of Health/National Institute of Neurological Disorders and Stroke U54NS081763-01S1). Dr Rundek is funded by the Florida Department of Health for work on the Florida Stroke Registry and by the grants from National Institutes of Health (R01 MD012467, R01 NS029993, R01 NS040807, 1U24 NS107267), and the National Center for Advancing Translational Sciences (UL1 TR002736 and KL2 TR002737). The remaining authors have no disclosures to report.
Funding Information:
This study is supported by the National Institutes of Health/National Institute of Neurological Disorders and Stroke Grant U54-NS081763 and the Florida Department of Health Funding #:COHAN-A1.
Publisher Copyright:
© 2021 The Authors.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race-ethnic and sex differences in door-to-CT (DTCT) ≤25 minutes in the FSR (Florida Stroke Registry). METHODS AND RESULTS: Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator-treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT ≤25. DTCT ≤25 was achieved in 56% of cases of suspected acute stroke, improving from 36% in 2010 to 72% in 2018. Women (odds ratio [OR], 0.90; 95% CI, 0.87–0.93) and Black (OR, 0.88; CI, 0.84–0.94) patients who had strokes were less likely, and Hispanic patients more likely (OR, 1.07; CI, 1.01–1.14), to achieve DTCT ≤25. In a secondary analysis among intravenous tissue plasminogen activatortreated patients, 81% of patients achieved DTCT ≤25. In this subgroup, women were less likely to receive DTCT ≤25 (0.85, 0.77–0.94) whereas no significant differences were observed by race or ethnicity. CONCLUSIONS: In the FSR, there was considerable improvement in acute stroke care metric DTCT ≤25 in 2018 in comparison to 2010. However, sex and race-ethnic disparities persist and require further efforts to improve performance and reduce these disparities.
AB - BACKGROUND: Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race-ethnic and sex differences in door-to-CT (DTCT) ≤25 minutes in the FSR (Florida Stroke Registry). METHODS AND RESULTS: Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator-treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT ≤25. DTCT ≤25 was achieved in 56% of cases of suspected acute stroke, improving from 36% in 2010 to 72% in 2018. Women (odds ratio [OR], 0.90; 95% CI, 0.87–0.93) and Black (OR, 0.88; CI, 0.84–0.94) patients who had strokes were less likely, and Hispanic patients more likely (OR, 1.07; CI, 1.01–1.14), to achieve DTCT ≤25. In a secondary analysis among intravenous tissue plasminogen activatortreated patients, 81% of patients achieved DTCT ≤25. In this subgroup, women were less likely to receive DTCT ≤25 (0.85, 0.77–0.94) whereas no significant differences were observed by race or ethnicity. CONCLUSIONS: In the FSR, there was considerable improvement in acute stroke care metric DTCT ≤25 in 2018 in comparison to 2010. However, sex and race-ethnic disparities persist and require further efforts to improve performance and reduce these disparities.
KW - Disparities
KW - Ethnicity
KW - Ischemic stroke
KW - Race
KW - Sex
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U2 - 10.1161/JAHA.120.017543
DO - 10.1161/JAHA.120.017543
M3 - Article
C2 - 33787282
AN - SCOPUS:85104046710
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 7
M1 - e017543
ER -