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    Home » Racial and Ethnic Disparities in Thrombectomy in the United States
    STROKE ALERT

    Racial and Ethnic Disparities in Thrombectomy in the United States

    September 1, 2019
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    Keywords

    Hispanics

    black

    thrombectomy

    ethnic

    By Matthew E. Fink, MD

    Louis and Gertrude Feil Professor and Chair, Department of Neurology; Associate Dean for Clinical Affairs, NewYork Presbyterian/Weill Cornell Medical College

    Dr. Fink reports no financial relationships relevant to this field of study.

    SOURCE: Rinaldo L, Rabinstein AA, Cloft H, et al. Racial and ethnic disparities in the utilization of thrombectomy for acute stroke. Analysis of data from 2016 to 2018. Stroke 2019; 50:00-00. DOI: 10.1161/STROKEAHA.118.024651. [Epub ahead of print].

    Mechanical thrombectomy for the treatment of acute ischemic stroke secondary to large vessel occlusion has been accepted and widely deployed in hospitals throughout the United States. However, disparities of treatment across various ethnic and racial groups has not been examined carefully to ensure uniform application of this treatment. The investigators reviewed admissions for acute ischemic stroke to endovascular centers occurring between January 2016 and September 2018 from a national database. They determined the number of patients who were treated with intravenous thrombolysis as well as mechanical thrombectomy at each institution, and recorded patient demographics, including age, sex, race, ethnicity, and insurance status. Demographic variables independently associated with utilization of mechanical thrombectomy were identified using a multivariate linear regression analysis.

    There were 206,853 admissions to 173 endovascular centers during the time interval that was explored. Overall utilization of mechanical thrombectomy was 8.4% of acute ischemic stroke patients. The utilization of endovascular mechanical thrombectomy for black and Hispanic patients was lower than among white and non-Hispanic patients (7.0% vs. 9.8%). Black and Hispanic patients also were less likely to receive intravenous thrombolysis (16.2% vs. 20.5%), or to be admitted to the endovascular center after transfer (20% vs. 30%). In a multivariate linear regression analysis, it was determined that presence of female sex, uninsured status or insurance with Medicaid, and having black or Hispanic race/ethnicity were independently associated with a lower utilization of mechanical thrombectomy. Stroke centers need to address these disparities and focus on the underlying causes that explain them.

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    Neurology Alert

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    Neurology Alert (Vol. 39, No. 1) - September 2019
    September 1, 2019

    Table Of Contents

    Antisense Oligonucleotide Treatment of Huntington’s Disease: A Novel Potential Treatment

    Calcitonin Gene-Related Peptide Targeting Therapies for Migraine

    Targeting Fyn Kinase in Alzheimer’s Disease: Another Failed Clinical Trial

    Risk of Neuropathy With Fluoroquinolones

    Racial and Ethnic Disparities in Thrombectomy in the United States

    After Ischemic Stroke Related to Atrial Fibrillation, Direct Oral Anticoagulants Are Superior to Vitamin K Antagonists

    Faster Time to Endovascular Reperfusion Therapy Results in Better Outcomes

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    Buy this Issue/Course

    Financial Disclosure: Neurology Alert’s Editor in Chief Matthew Fink, MD; Peer Reviewer M. Flint Beal, MD; Editorial Group Manager Leslie Coplin; Editor Jason Schneider; and Accreditations Manager Amy M. Johnson, MSN, RN, CPN, report no financial relationships relevant to this field of study.

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