Various sociodemographic variables on acute and inpatient stroke care

Abstract

Background: Key factors affecting stroke outcomes include swift diagnosis and early treatment, however, disparities in symptom recognition, particularly in minority groups, impact timely care. This study examines the influence of patient characteristics on stroke metrics, focusing on factors such as age, sex, ethnicity, race, insurance status, and language preference.

Methods: We conducted a multicenter, retrospective study using the National Hospital Corporation of America (HCA) database, analyzing 37,956 acute ischemic stroke (AIS) cases from 170 HCA hospitals between 2017 and 2022. We evaluated the impact of demographic and patient-specific factors on tPA administration rates, time-to-tPA (TtPA), and hospital length of stay (LOS). Statistical methods included odds ratios, one-way ANOVA, mixed-effects models, and negative binomial regression.

Results: Factors affecting tPA administration included age, sex, and insurance status. Patients aged 45 and older and those with Medicaid or Medicare were less likely to receive tPA. NIH Stroke Scale (NIHSS) scores significantly influenced tPA administration rates and TtPA. Language preference did not impact tPA administration rates or TtPa, but non-English speakers experienced longer hospital stays. Hispanic and Black patients also had longer LOS compared to non-Hispanic and White patients, respectively.

Conclusion: This study underscores the need for targeted interventions to address disparities in stroke management and outcomes. Future research should explore the underlying causes of these differences and develop strategies to enhance stroke care equity across diverse patient populations.

Keywords: Analysis of variance; Length of stay; Medicaid; Minority groups; Racial groups; Retrospective studies; Stroke.