Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 8:29:100421.
doi: 10.1016/j.ensci.2022.100421. eCollection 2022 Dec.

Decompressive hemicraniectomy for stroke by race/ethnicity in the United States

Alain Lekoubou  1 , Cyril Tankam  2 , Kinfe G Bishu  3   4 , Bruce Ovbiagele  5
Affiliations

Decompressive hemicraniectomy for stroke by race/ethnicity in the United States

Alain Lekoubou et al. eNeurologicalSci. .

Abstract

Objective: Racial and ethnic differences in the performance of indicated neurosurgical procedures have been reported. However, it is not clear whether there are racial or ethnic differences in the performance of decompressive hemicraniectomy (DHC) for acute ischemic stroke. This study evaluated the rate, trends, and independent association of race and ethnicity with DHC among hospitalized ischemic stroke patients in the United States.

Materials and methods: We used the International Classification of Diseases, Clinical Modification (ICD-9-CM) to identify adult patients (18-year-old and older) with a primary discharge diagnosis of ischemic stroke, excluding those with a posterior circulation ischemic stroke in the Nationwide Inpatient Sample between 2006 and 2014. We computed the rate and trends of DHC. We then applied a multivariable logistic regression model to evaluate the independent association of race with DHC.

Results: A total 715,649 patients had anterior ischemic stroke, including 1514 who underwent DHC (2.1 per 1000). The rate of DHC increased overall from 1 per 1000 in 2006 to 3 per 1000 in 2014. Similar upward trends were noted among Non-Hispanic Whites, Non-Hispanic Blacks, and Hispanics. Hispanics with anterior ischemic stroke were 1.28 times more likely than non-Hispanic Whites to have DHC but no difference was observed between Non-Hispanic Blacks and Non-Hispanic Whites.

Conclusions: In this nationally representative sample of patients with anterior ischemic strokes, being of Hispanic ethnicity was independently associated with a higher frequency of receiving DHC compared to being Non-Hispanic White. Future studies should confirm this difference and explore the underlying reasons for it.

Keywords: Ethnicity; Hemicraniectomy; Race; Stroke; United States.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Mayer S.A. Hemicraniectomy: a second chance on life for patients with space-occupying MCA infarction. Stroke. 2007;38(9):2410–2412. doi: 10.1161/STROKEAHA.107.494203. - DOI - PubMed
    1. Liebeskind D.S., Jüttler E., Shapovalov Y., et al. Cerebral edema associated with large hemispheric infarction. Stroke. 2019;50(9):2619–2625. doi: 10.1161/strokeaha.118.024766. - DOI - PubMed
    1. Hacke W. ‘Malignant’ middle cerebral artery territory infarction. Arch. Neurol. 1996;53(4):309. doi: 10.1001/archneur.1996.00550040037012. - DOI - PubMed
    1. Staykov D., Gupta R. Hemicraniectomy in malignant middle cerebral artery infarction. Stroke. 2011;42(2):513–516. doi: 10.1161/strokeaha.110.605642. - DOI - PubMed
    1. Howard V.J., Kleindorfer D.O., Judd S.E., et al. Disparities in stroke incidence contributing to disparities in stroke mortality. Ann. Neurol. 2011;69(4):619–627. doi: 10.1002/ana.22385. - DOI - PMC - PubMed

LinkOut - more resources