Asian American patients manifested more severe ischemic strokes, were less likely to receive intravenous tissue plasminogen activator (IV tPA), and had worse functional outcomes than white patients, according to a recent study. Researchers conducted a retrospective analysis of Asian American and white patients admitted with a primary diagnosis of acute ischemic stroke to hospitals participating in the Get With The Guidelines–Stroke (GWTG-Stroke) program between April 1, 2004, and July 31, 2016. They found:
- A population of 1,772,299 patients consisted of 64,337 Asian American patients (3.6%) and 1,707,962 white patients (96.4%) admitted to 2,171 GWTG-Stroke hospitals with acute ischemic stroke.
- After adjustment for patient and hospital variables, Asian American patients were seen with greater stroke severity compared with white patients (National Institutes of Health Stroke Scale [NIHSS] score ≥16), manifested higher in-hospital mortality, had longer length of stay, and were less likely to ambulate independently at discharge.
- Although Asian American patients had fewer IV tPA administrations than white patients, they had more symptomatic hemorrhage after tPA and overall post-tPA complications.
Song S, Liang L, Fonarow GC, et al. Comparison of clinical care and in-hospital outcomes of Asian American and white patients with acute ischemic stroke. [Published online ahead of print January 22, 2019]. JAMA Neurology. doi:10.1001/jamaneurol.2018.4410.