Department of Radiology
University of Wisconsin School of Medicine and Public Health

Polineni 2021

 

Year: 2021

Title: Sex and race-ethnic disparities in door-to-ct time in acute ischemic stroke: The florida stroke registry

Country: United States

Age: Adult Only

Sex: All Sexes

Population: Multiple Groups

Care Setting: Inpatient and Outpatient

Clinical Setting: Stroke Imaging

Data Level: State

Data Type: Disease Registry

Data Source: Florida Stroke Registry

Conclusion: Disparities In Some Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Black patients who had strokes were less likely, and Hispanic patients more likely to achieve door-to-CT time of 25 minutes.

Abstract: BACKGROUND: Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race-ethnic and sex differences in door-to-CT (DTCT) 25 minutes in the FSR (Florida Stroke Registry). METHODS AND RESULTS: Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator-treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT 25. DTCT 25 was achieved in 56% of cases of suspected acute stroke, improving from 36% in 2010 to 72% in 2018. Women (odds ratio [OR], 0.90; 95% CI, 0.87-0.93) and Black (OR, 0.88; CI, 0.84-0.94) patients who had strokes were less likely, and Hispanic patients more likely (OR, 1.07; CI, 1.01-1.14), to achieve DTCT 25. In a secondary analysis among intravenous tissue plasminogen activator-treated patients, 81% of patients achieved DTCT 25. In this subgroup, women were less likely to receive DTCT 25 (0.85, 0.77-0.94) whereas no significant differences were observed by race or ethnicity. CONCLUSIONS: In the FSR, there was considerable improvement in acute stroke care metric DTCT 25 in 2018 in comparison to 2010. However, sex and race-ethnic disparities persist and require further efforts to improve performance and reduce these disparities.