The racial disparity in stroke is an enormous public concern

1. Racial/Ethnic Differences in Mortality among Patients Hospitalized with Intracerebral Hemorrhage Ying Xian,1 Robert G. Holloway,2 Eric E. Smith,3 Lee H. Schwamm,4 Mathew J. Reeves,5 Margueritte Cox,1DaiWai M. Olson,1 Adrian F. Hernandez,1 Barbara Lytle,1 Gregg C. Fonarow,6 Eric D. Peterson,1 1Duke Clinical Research Institute, Durham, NC; 2University of Rochester, Rochester, NY; 3Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada; 4Department of Neurology, Massachusetts General Hospital, Boston, MA; 5Department of Epidemiology, Michigan State University, East Lansing, MI; 6Division of Cardiology, University of California, Los Angeles, CA Background Results Table 2. In-hospital Mortality by Race Table 1. Baseline Characteristics by Race • The racial disparity in stroke is an enormous public concern • Despite higher burden of stroke in minorities, limited data exists in comparing mortality for patients with intracerebral hemorrhage of different racial and ethnic backgrounds Methods • Data from 123,736 patients with intracerebral hemorrhage admitted to 1,199 Get With The Guidelines-Stroke (GWTG) hospitals between 2003-2012 • Multivariate logistic regressions with generalized estimating equations were performed to evaluate the association between race and in-hospital mortality • We adjusted for patient-level characteristics including age, gender, and medical history, as well as hospital-level characteristics including region, hospital type, size, primary stroke center status, percentage of minority patients treated, number of ICH admissions per year, and calendar time • Sensitivity analyses among patients with complete National Institutes of Health Stroke Scale score (NIHSS) • To determine whether racial/ethnic differences in mortality varied by age, we further examined the interaction between age and race • Black, Hispanic, and other racial/ethnic patients were less likely to die in-hospital than white patients after adjustment for patient and hospital characteristics. The mortality differences remained consistent after further adjustment for NIHSS in NIHSS complete records • After examining age and race interaction, the mortality difference was observed in older age groups, but was not evident in younger age groups • In contrast to lower mortality, minorities had longer length of stay than white patients (median 6, 6, 6, and 5 days for black, Hispanic, other, and white, respectively, p<.001) Conclusions • Compared with white patients, black, Hispanic, and other race were younger • Minorities had less comorbidities except for diabetes mellitus and hypertension, and had more severe stroke as documented by NIHSS • Among patients hospitalized with intracerebral hemorrhage, black, Hispanic, and other racial/ethnic groups have lower risk-adjusted in-hospital mortality compared to white patients, though these racial/ethnic differences were largely confined to patients age 60 years and older FUNDING STATEMENT: The Get With The Guidelines®–Stroke (GWTG-Stroke) program is provided by the American Heart Association/American Stroke Association. The GWTG-Stroke program is currently supported in part by a charitable contribution from Janssen Pharmaceutical Companies of Johnson & Johnson. GWTG-Stroke has been funded in the past through support from Boeringher-Ingelheim, Merck, Bristol-Myers Squib/Sanofi Pharmaceutical Partnership and the AHA Pharmaceutical Roundtable. DISCLOSURE INFORMATION (relative only): Eric D. Peterson, PI of the AHA GWTG Data Analysis Center; Lee H. Schwamm, Chair of the AHA National Steering Committee for GWTG (unpaid)