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Multicenter Study
. 2017 Apr 20;27(2):125-132.
doi: 10.18865/ed.27.2.125. eCollection 2017 Spring.

Race-Ethnic Disparities in Hospital Arrival Time after Ischemic Stroke

Mellanie V Springer  1 , Daniel L Labovitz  1 , Ethan C Hochheiser  1
Affiliations
Multicenter Study

Race-Ethnic Disparities in Hospital Arrival Time after Ischemic Stroke

Mellanie V Springer et al. Ethn Dis. .

Abstract

Objective: Conflicting reports exist about hospital arrival time after stroke onset in Hispanics compared with African Americans and Caucasians. Our current study investigates race-ethnic disparities in hospital arrival times after stroke onset.

Methods: We performed a retrospective analysis of hospital arrival times in Hispanic, African American, and Caucasian acute ischemic stroke patients (N=1790) presenting to a tertiary-care hospital in the Bronx, New York. A multivariable logistic regression model was used to identify the association between race-ethnicity and hospital arrival time adjusting for age, sex, socioeconomic status (SES), NIH stroke scale (NIHSS), history of stroke, preferred language and transportation mode to the hospital.

Results: There were 338 Caucasians, 662 Hispanics, and 790 African Americans in the cohort. Compared with Caucasians, African Americans and Hispanics were younger (P<.0001 respectively), had lower SES (P<.001 respectively) and were less likely to use EMS (P=.003 and P=.001, respectively). A greater proportion of Hispanic and African American women had delayed hospital arrival times (≥3 hours) after onset of stroke symptoms compared with Caucasian women (74% of Hispanic, 72% of African American, and 59% of Caucasian women), but this difference between race-ethnicities is no longer present after adjusting for socioeconomic status. Compared with Caucasian men, hospital arrival ≥3 hours after symptom onset was more likely for African American men (OR 1.72, 95% CI:1.05-2.79) but not Hispanic men (OR .80, 95% CI .49-1.30).

Conclusions: African American men and socially disadvantaged women delay in presenting to the hospital after stroke onset. Future research should focus on identifying the factors contributing to pre-hospital delay among race-ethnic minorities.

Keywords: African Americans; Delay; Health Care Disparities; Hispanics; Race; Stroke.

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Conflict of interest statement

Competing Interests: None declared.

Figures

Figure 1.
Figure 1.. Excluded patients
See this image and copyright information in PMC

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