National Versus State-Level Racial Disparities in Acute Stroke Interventions Using Get With The Guidelines-Stroke...

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• Racial disparities in stroke care are documented, necessitating an understanding of regional variations.
• Focusing policies and resources requires analysis of geographic inequities in stroke treatment.

Purpose of the Study:

• To investigate racial and ethnic disparities in thrombolysis and thrombectomy administration.
• To examine these disparities at both national and state levels within the United States.

Main Methods:

• Retrospective cohort study utilizing Get With The Guidelines-Stroke Program registry data (2003-2022).
• Mixed-effects modeling was employed to analyze national and state-level disparities.
• Adjustments were made for demographic, clinical, and hospital-level characteristics.

Main Results:

• Nationally, non-Hispanic Black patients had similar or higher rates of thrombolysis compared to non-Hispanic White patients.
• State-level analysis revealed disparities in thrombolysis for non-Hispanic Black patients in some stroke-belt states.
• Significant racial disparities were observed in the national utilization of endovascular thrombectomy, favoring non-Hispanic White patients.

Conclusions:

• Racial and ethnic disparities in stroke care are intervention- and location-dependent.
• National thrombolysis equity may reflect quality improvement successes, but state-level inequities persist.
• Race-based disparities in thrombectomy necessitate further efforts to ensure equitable stroke care.