Black patients may be at a higher mortality risk following ischemic stroke compared to patients of other races, according to findings presented during the International Stroke Conference, held remotely from March 17th to the 19th, 2021.

Study researchers sought to identify the 10-year mortality outcomes of elderly stroke patients in the United States by analyzing the race of patients and their long term survivorship.

This study included a total of 744,044 fee-for-service Medicare beneficiaries (mean age, 78.7 years). The majority of patients were women (54.7%) and White (85.6%). They had been discharged from acute care with a diagnosis of ischemic stroke between the years of 2005 and 2007.

Patient follow-up continued until 2016. Using inverse probability weighting (IPW), study researchers assessed their race differences in mortality risk by inverse probability weighting (IPW). They used a logistic regression model to identify a patient’s race based on age, Medicaid eligibility, comorbidities, in-hospital complications, discharge disposition, duration of stay and Medicare payment. A cox regression model was used to identify the relationship between race and 10-year mortality.


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Among the 744,044 patients discharged with ischemic stroke, the percentage of Black patients (9.9%) included were mainly women who were younger. Additionally, the study indicated that Black patients were more susceptible to comorbidities such as renal failure, dementia, and diabetes, while White patients were more prone to chronic obstructive pulmonary disease (COPD) and atherosclerosis.

After analyzing the 10 year mortality rate (75.3%) for the entire study population, study researchers determined that Black patients had the highest mortality rate (76.4%), followed by White patients (75.4%), and then those of other races (70.3%). When compared with White patients, risk of death within 10 years of stroke was increased for Black patients (RR=1.04, 95% CI, 1.03-1.04) and decreased for all other races (RR=0.92; 95% CI, 0.90-0.93).

Study researchers determined a correlation between an increased mortality risk and race among stroke survivors. They concluded that “more than 75% of stroke patients died within 10 years” and the risk was “higher for Black stroke patients even after accounting for sociodemographic and index hospitalization factors.”

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of author disclosures.

Reference

Lichtman JH, Leifheit EC, Wang Y, Arakaki A, Goldstein LB. Race differences In 10-year mortality after ischemic stroke.  Presented at: International Stroke Conference; March 17-19, 2021. Abstract P655.