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Related Experiment Video

Updated: Oct 20, 2025

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Multiple Chronic Conditions Explain Ethnic Differences in Functional Outcome Among Patients With Ischemic Stroke.

Xiaqing Jiang1, Lewis B Morgenstern1,2, Christine T Cigolle3,4

  • 1Departments of Epidemiology (X.J., L.B.M., L.D.L.), School of Public Health, University of Michigan.

Stroke
|September 14, 2021
PubMed
Summary

Mexican Americans experience worse stroke outcomes due to higher multiple chronic conditions (MCC) burden. Managing MCC can help reduce ethnic disparities in stroke functional outcomes.

Keywords:
comorbidityethnic groupsmultiple chronic conditionsprognosisstroke

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Area of Science:

  • Neurology
  • Public Health
  • Health Disparities

Background:

  • Mexican Americans (MAs) face poorer stroke outcomes and distinct multiple chronic conditions (MCC) profiles compared to non-Hispanic White individuals.
  • MCC significantly impacts stroke treatment, complications, and poststroke care, ultimately affecting functional outcomes (FO).

Purpose of the Study:

  • To evaluate the extent to which MCC contributes to the ethnic disparities in FO at 90 days post-stroke between MAs and non-Hispanic White people.

Main Methods:

  • A prospective cohort study of ischemic stroke patients (2008-2016) in Nueces County, Texas.
  • MCC burden assessed using a stroke-specific index; FO measured by activities of daily living (ADLs) at 90 days.
  • Tobit regression used to analyze MCC's contribution to ethnic differences in FO, with examination of effect modification by ethnicity.

Main Results:

  • MAs exhibited a higher age-adjusted MCC burden than non-Hispanic White individuals.
  • Higher MCC scores correlated with worse FO at 90 days (0.70 points higher FO score for high vs. low MCC).
  • MCC accounted for 19% of the ethnic difference in FO; effect modification by ethnicity was not significant.

Conclusions:

  • Elevated age-adjusted MCC burden in MAs partially explains ethnic disparities in poststroke FO.
  • Targeting MCC prevention and treatment may mitigate functional impairment and reduce ethnic disparities in stroke outcomes.