Risk factors, clinical presentation, stroke subtype and short-term outcome following acute stroke in a multi-ethnic...

Stroke remains a leading global cause of disability and mortality with over 100 million patients affected worldwide. Its incidence has risen in recent decades, especially in low- and middle-income countries (LMICs), due to limited education, healthcare, and effective prevention measures. This study investigates the association between ethnicity and outcomes of stroke in Qatar, a country with a heterogeneous population.

Data from 18,174 stroke patients admitted to Hamad General Hospital from 2014 to 2024 were analyzed. We assessed patient characteristics, stroke types, comorbidities, and outcomes using the NIH Stroke Scale and modified Rankin Scale (mRS).

There were significant ethnic differences in stroke presentation and outcomes. Middle Easterns were older (59.7 ± 14.2) than South East Asian (50.1 ± 11.7) and Far Eastern (47.5 ± 9.85) patients; p < 0.001. Middle Eastern patients had a higher prevalence of stroke risk factors (diabetes, hypertension, obesity) and stroke mimics (39.8%) than Southeast Asian (21.7%) and Far Eastern (27.7%) patients (p < 0.0001). Far Eastern patients demonstrated a higher incidence (17.6%) of intracerebral hemorrhage compared to Middle Easterns (6.2%) and East Asians (10.6%); p < 0.0001. However, ischemic stroke was more common among Southeast Asians (58.6%) than Middle Eastern (43.8%) and Far Eastern (44.4%) patients; p < 0.0001. Lastly, there were significant differences in outcomes as measured by mortality and the mRS.

There are significant ethnic differences in stroke presentation, management, and outcomes in Qatar, some of which may reflect underlying disparities driven by social and structural inequities. While genetic differences play a role, early management of vascular risk factors is a crucial, preventable measure to reduce stroke burden in LMICs and improve health outcomes.