在患有中风后抑郁症的黑人和白人患者中,中风复发风险和死亡率
Jack Gomberg1, Laura K Stein2, Mandip S Dhamoon2
1Department of Medical Education (J.G.), Icahn School of Medicine at Mount Sinai, New York, NY.
Stroke
|April 3, 2024
概括
与白人患者相比,患有中风后抑郁症 (PSD) 的黑人患者患中风复发的风险更高. 解决社会决定因素和系统性种族主义对于改善种族少数群体中风后结果至关重要.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 脑卒中后抑郁症 (PSD) 是中风的常见,可治疗的并发症.
- 在少数群体中,PSD往往被诊断不足和治疗不足.
- 在PSD结果中的种族差异需要调查.
研究的目的:
- 为了比较黑人和白人的PSD患者在美国的结果.
- 确定种族是否是PSD患者中复发性中风和死亡率的独立预测因素.
主要方法:
- 对非识别的医疗保险数据 (2016-2019年) 的回顾性队列分析.
- 在中风6个月内使用ICD-10代码识别PSD患者.
- 使用卡普兰-梅尔和考克斯回归来分析按种族的复发性中风和死亡风险.
主要成果:
- 患有PSD的黑人患者在中风后3年内持续增加复发性中风的累积风险 (日志排名P=0.0011).
- 黑人种族是增加复发性中风风险的独立预测因素 (HR,1.198;P=0.0259).
- 白人患PSD患者最初较高的死亡风险在调整辅因子后消失了.
结论:
- 患有PSD的黑人患者面临的复发性中风风险高于白人患者.
- 种族是PSD中复发性中风的独立预测因素.
- 解决健康和系统性种族主义的社会决定因素对于公平的中风后护理至关重要.
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