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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Acute ischemic strokes in patients with developmental disabilities: A cross-sectional analysis
Aiden Lui1, Eric Feldstein2, Kevin Clare1
1School of Medicine, New York Medical College, Valhalla, NY, USA.
Summary
Patients with developmental disabilities (DD) receive less acute ischemic stroke (AIS) treatment, including tissue plasminogen activator (tPA) and endovascular thrombectomy (EVT). However, outcomes after EVT were similar for those with and without DD.
Area of Science:
- Neurology
- Public Health
- Clinical Research
Background:
- Patients with developmental disabilities (DD) are often excluded from acute ischemic stroke (AIS) clinical trials.
- Understanding treatment disparities and outcomes in this population is crucial for equitable care.
Purpose of the Study:
- To evaluate the impact of developmental disabilities on acute ischemic stroke treatment and outcomes.
- To compare clinical characteristics, treatments, and discharge dispositions of AIS patients with and without DD.
Main Methods:
- Analysis of the National Inpatient Sample (NIS) database from 2010-2019.
- Comparison of AIS patients with DD (n=4094) versus fully-abled patients (n=1,601,629).
- Propensity score-matched analysis for patients undergoing endovascular thrombectomy (EVT).
Main Results:
- AIS patients with DD were younger, less likely to be Caucasian, and had higher stroke severity.
- Patients with DD received tissue plasminogen activator (tPA) less frequently (4.79% vs 6.2%) and EVT less frequently (0.85% vs 1.31%).
- Developmental disabilities predicted lower rates of tPA and EVT; however, post-EVT functional outcomes, in-hospital mortality, and length of stay (LOS) were similar between groups.
Conclusions:
- AIS patients with DD experience disparities in receiving advanced stroke treatments like tPA and EVT.
- Despite lower treatment rates, functional outcomes after EVT were comparable, suggesting potential for similar benefits.
- Population-based studies are vital for informing clinical practice in the absence of prospective trials for this underrepresented group.
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