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Published on: September 22, 2020
Stroke Outcomes Among English- and Spanish-Speaking Mexican American Patients
Alejandro Vargas1, Guanghao Zhang1, Xu Shi1
1From the Department of Neurological Sciences (A.V.), Rush University Medical Center, Chicago, IL; and Department of Biostatistics (G.Z., X.S.), and Stroke Program (L.D.L., L.B.M.), Michigan Medicine and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
Objectives:
We examined whether language preference was associated with 90-day poststroke outcomes among Mexican American (MA) patients.
Methods:
Patients with ischemic stroke and intracerebral hemorrhage from the population-based Brain Attack Surveillance in Corpus Christi project (2009-2018) were compared by language preference in 90-day neurologic, functional, and cognitive outcomes using weighted Tobit regression. Models were adjusted for demographics, initial NIH Stroke Scale (NIHSS), medical history, stroke characteristics, and insurance status.
Results:
Of 1,096 stroke patients, 926 were English-speaking and 170 were Spanish-only-speaking. Spanish speakers were older (p < 0.01), received less education (p < 0.01), had higher initial NIHSS values (p = 0.02), had higher prevalence of atrial fibrillation (p < 0.01), and had lower prevalence of smoking (p = 0.01) than English speakers. In fully adjusted models, Spanish-only speakers had worse neurologic outcome (NIHSS, range 0-44 [higher worse], mean difference: 1.93, p < 0.01) but no difference in functional outcome measured by activities of daily living/instrumental activities of daily living or cognitive outcome compared with English speakers.
Discussion:
This population-based study found worse neurologic but similar functional and cognitive stroke outcomes among Spanish-only-speaking MA patients compared with English-speaking MA patients.
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