Racial and Ethnic Disparities in Ischemic Stroke Severity in the National Inpatient Sample Between 2018 and 2021

Area of Science:

• Neurology
• Public Health
• Health Disparities

Background:

• Stroke severity varies significantly among different demographic groups.
• Understanding racial and ethnic disparities in ischemic stroke is crucial for public health.
• Previous research has indicated potential differences in stroke outcomes based on race.

Purpose of the Study:

• To investigate the association between race/ethnicity and the severity of ischemic stroke.
• To identify potential health disparities in acute ischemic stroke care within the United States.
• To provide data on stroke severity across diverse racial and ethnic populations.

Main Methods:

• Analysis of adult hospital discharges for ischemic stroke from the National Inpatient Sample (2018-2021).
• Stratification of the cohort by self-reported race and ethnicity.
• Evaluation of stroke severity using the National Institutes of Health Stroke Scale (NIHSS), with age- and sex-adjusted linear regression models.

Main Results:

• A total of 231,396 ischemic stroke discharges were analyzed, with a mean NIHSS of 6.5±7.2.
• Non-White patients, including Black (7.12) and Hispanic (6.86) individuals, exhibited higher age- and sex-adjusted NIHSS scores compared to White patients (6.25).
• These disparities persisted after adjusting for comorbidities, socioeconomic factors, and other health conditions.

Conclusions:

• A significant association exists between non-White race/ethnicity and increased ischemic stroke severity.
• These findings suggest an underappreciated health disparity in the acute care of ischemic stroke patients.
• Addressing these disparities is essential for equitable stroke outcomes across all populations.