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Prehospital Thrombolysis: A Manual from Berlin

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Published on: November 26, 2013

Racial Disparity in Mechanical Thrombectomy Utilization: Multicenter Registry Results From 2016 to 2020.

Adam N Wallace¹, Daniel P Gibson¹, Kaiz S Asif²

¹Neurointerventional Surgery Ascension Columbia St. Mary's Hospital Milwaukee WI.

Journal of the American Heart Association

|February 14, 2022

Summary

Black patients with stroke received mechanical thrombectomy (MT) less often than White patients. This disparity is linked to longer times from symptom onset to hospital arrival and fewer documented large vessel occlusions.

Keywords:

disparities race stroke thrombectomy

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Area of Science:

Neurology
Public Health
Health Disparities

Background:

Previous studies on racial disparities in mechanical thrombectomy (MT) for acute large vessel occlusion (LVO) stroke lacked individual patient data.
This study examined patient-level data to assess racial disparities in MT utilization and eligibility within a large US healthcare system.

Purpose of the Study:

To investigate racial disparities in the utilization and eligibility of mechanical thrombectomy (MT) for acute large vessel occlusion (LVO) stroke.
To identify factors contributing to potential disparities in MT treatment.

Main Methods:

Retrospective analysis of 34,596 patients (23% African American/Black, 77% White, non-Hispanic) from 43 hospitals (2016-2020).
Data included demographics, socioeconomic factors, stroke severity, and time to treatment.
Multivariable logistic regression was used to analyze MT utilization and eligibility.

Main Results:

Black patients were less likely to undergo MT (aOR, 0.65).
Black patients had longer times from "last known well" to hospital arrival (aOR, 0.73).
Black patients had a lower rate of documented anterior circulation LVO (aOR, 0.78).

Conclusions:

Black patients with stroke underwent MT less frequently than White patients.
Disparities may be attributed to longer pre-hospital arrival times and lower rates of documented LVO.
Further research should explore extending MT time windows and improving LVO screening to mitigate disparities.