Socioeconomic Disparities in the Utilization of Mechanical Thrombectomy for Acute Ischemic Stroke in US Hospitals

Brinjikji, Waleed; Rabinstein, Alejandro A.; McDonald, Jennifer S.; Cloft, Harry J.

doi:10.3174/ajnr.a3708

Cited by 48 publications

(44 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are similar to those by Brinjikji et al in 2013. 12 Their study included 371 cases and found a .59 lower odds of thrombectomy utilization in AA, compared with NHW (P<.001).…”

Section: Discussionmentioning

confidence: 95%

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

et al. 2020

View full text Add to dashboard Cite

Background: Compared with non-Hispanic Whites (NHW), racial-ethnic minorities bear a disproportionate burden of stroke and receive fewer evidence-based stroke care processes and treatments. Since 2015, mechanical thrombectomy (MT) has become standard of care for acute ischemic stroke (AIS) patients with proximal anterior circulation large vessel occlusion (LVO).Objectives: Our objectives were to: assess recent trends in nationwide MT utilization among patients with AIS; determine if there were racial differences; and identify what factors were associated with such differences.Methods: We performed a retrospective cohort study using nationally representative data of a non-institutionalized population sample from 2006 to 2014 obtained from the Nationwide Inpatient Sample (NIS). We identified a total of 889,309 observations of AIS, of which there were 5,256 MT observations.Results: In the fully adjusted model, rate of thrombectomy utilization was significantly lower in African Americans (AA) (OR .67, CI .58-.76, P<.001) compared with NHW and Hispanics (OR .94, CI .78-1.13, P=.5).Conclusion: We found a significant disparity in MT utilization for AA compared with NHW and Hispanics. More work is needed to understand the drivers of this racial disparity in stroke treatment. Ethn Dis. 2020;30(1):91-96; doi:10.18865/ed.30.1.91

show abstract

“…These findings are similar to those by Brinjikji et al in 2013. 12 Their study included 371 cases and found a .59 lower odds of thrombectomy utilization in AA, compared with NHW (P<.001).…”

Section: Discussionmentioning

confidence: 95%

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

et al. 2020

View full text Add to dashboard Cite

show abstract

“…[31][32][33] Among adult stroke patients, African-Americans, the uninsured, and Medicare patients have been shown to be less likely to receive endovascular therapy. 34 The impact of insurance status, socioeconomic status, and race on pediatric stroke interventions, access to care, and outcomes is an area that warrants further study. Seizure was less common in the endovascular therapy group, which may be explained by the higher rates of seizures in younger children in this cohort, consistent with other reports in pediatric stroke.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes

Wilson

Eriksson

Williams

2017

Pediatric Neurology

View full text Add to dashboard Cite

In a national sample of children with a diagnosis of arterial ischemic stroke, endovascular therapy was infrequently utilized. Patients with a procedure code for endovascular therapy had significant stroke-related deficits, but outcomes were similar to those in children who did not receive endovascular therapy. Our data, in conjunction with evidence of benefit in adults, support consideration of endovascular therapy for select children with acute stroke.

show abstract

“…Brinjikji et al 2 found that patients of lower socioeconomic status were less likely to undergo elective treatment of unruptured aneurysms that those of higher socioeconomic status. Patients of lower socioeconomic status are also less likely to receive intravenous tissue plasminogen activator and mechanical thrombectomy for acute ischemic stroke 5 15 16. Amaranto et al 17 demonstrated that Caucasian race was an independent predictor of surgical intervention for the treatment of carotid artery stenosis.…”

Section: Discussionmentioning

confidence: 99%

Racial and insurance based disparities in the treatment of carotid artery stenosis: a study of the Nationwide Inpatient Sample

Brinjikji

El-Sayed

Kallmes

et al. 2014

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

Socioeconomic Disparities in the Utilization of Mechanical Thrombectomy for Acute Ischemic Stroke in US Hospitals

Abstract: BACKGROUND AND PURPOSE:Previous studies have demonstrated that socioeconomic disparities in the treatment of cerebrovascular diseases exist. We studied a large administrative data base to study disparities in the utilization of mechanical thrombectomy for acute ischemic stroke.

Cited by 48 publications

References 22 publications

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes

Racial and insurance based disparities in the treatment of carotid artery stenosis: a study of the Nationwide Inpatient Sample

Contact Info

Product

Resources

About