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Age, Sex, and Racial Differences in Neuroimaging Use in Acute Stroke: A Population-Based Study.

A Vagal1, P Sanelli2, H Sucharew3

  • 1From the Departments of Radiology (A.V.) vagala@ucmail.uc.edu.

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Summary

Neuroimaging use for stroke varies by patient age and race, particularly in academic centers. These disparities depend on the care setting and patient age group, highlighting inequities in advanced stroke imaging.

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Area of Science:

  • Neurology
  • Radiology
  • Public Health

Background:

  • Limited data exists on racial, sex, and age-based disparities in neuroimaging for acute stroke.
  • Understanding these differences is crucial for equitable stroke care.

Purpose of the Study:

  • To investigate variations in advanced neuroimaging use for stroke work-up based on race, sex, and age.
  • To determine if these variations are influenced by the type of healthcare center.

Main Methods:

  • Utilized data from the Greater Cincinnati/Northern Kentucky Stroke Study (2005, 2010).
  • Included patients with stroke (ischemic/hemorrhagic) and transient ischemic attack.
  • Employed multivariable regression to analyze odds of advanced imaging (CT angiography, MR imaging, MR angiography).

Main Results:

  • Advanced imaging use was higher in younger patients, Black patients compared to White patients, and those treated at academic centers or by stroke specialists.
  • The association between race and advanced imaging differed by age group, with older Black patients showing higher odds.
  • Age-by-race interaction was significant in academic centers but not non-academic centers. No sex-based differences were observed.

Conclusions:

  • Significant variations in advanced neuroimaging use for stroke exist based on age and race.
  • These disparities are influenced by the type of care center and patient age.
  • Findings underscore the need for equitable neuroimaging practices in stroke management.