The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.
Race/Ethnicity, Quality of Care, and Outcomes in Ischemic Stroke
Open accessAbstract
Background— Prior studies suggest differences in stroke care associated with race/ethnicity. We sought to determine whether such differences existed in a population of black, Hispanic, and white patients hospitalized with stroke among hospitals participating in a quality-improvement program. Methods and Results— We analyzed in-hospital mortality and 7 stroke performance measures among 397 257 patients admitted with ischemic stroke to 1181 hospitals participating in the Get With The Guidelines-Stroke program 2003 through 2008. Relative to white patients, black and Hispanic patients were younger and more often had diabetes mellitus and hypertension. After adjustment for both patient- and hospital-level variables, black patients had lower odds relative to white patients of receiving intravenous thrombolysis (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.77 to 0.91), deep vein thrombosis prophylaxis (OR, 0.88; 95% CI, 0.83 to 0.92), smoking cessation (OR, 0.85; 95% CI, 0.79 to 0.91), discharge antithrombotics (OR, 0.88; 95% CI, 0.84 to 0.92), anticoagulants for atrial fibrillation (OR, 0.84; 95% CI, 0.75 to 0.94), and lipid therapy (OR, 0.91; 95% CI, 0.88 to 0.96), and of dying in-hospital (OR, 0.90; 95% CI, 0.85 to 0.95). Hispanic patients received similar care as their white counterparts on all 7 measures and had similar in-hospital mortality. Black (OR, 1.31; 95% CI, 1.28 to 1.35) and Hispanic (OR, 1.16; 95% CI, 1.11 to 1.20) patients had higher odds of exceeding the median length of hospital stay relative to whites. During the study, quality of care improved in all 3 race/ethnicity groups. Conclusions— Black patients with stroke received fewer evidence-based care processes than Hispanic or white patients. These differences could lead to increased risk of recurrent stroke. Quality of care improved substantially in the Get With The Guidelines-Stroke Program over time for all 3 racial/ethnic groups.
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“This racial profile is similar to existing studies in stroke but reflects issues with equity of access, considering the well-documented health inequalities in stroke.30,31”
From Wellbeing After Stroke (WAterS): Feasibility Testing of a Co-developed Acceptance and Commitment Therapy Intervention to Support Psychological Adjustment After Stroke. (2024) · cites this paper as [30]
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Citations
Cites
Unequal treatment: confronting racial and ethnic disparities in health care
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Heart Disease and Stroke Statistics—2009 Update
WRITING GROUP MEMBERS, Lloyd‐Jones, D. M., Adams, R. J., Carnethon, M. R., SIMONE, G. D., Ferguson, T. B., Flegal, K. M., Ford, E. S., Furie, K. L., Go, A. S., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.191259 · Cited by 3,915
WRITING GROUP MEMBERS, Lloyd-Jones, D., Adams, R., Carnethon, M., De Simone, G., Ferguson, T. B., Flegal, K., Ford, E., Furie, K., Go, A., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.191261 · Cited by 3,140
Models for Discrete Longitudinal Data
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Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics: The Northern Manhattan Study
White, H., Boden-Albala, B., Wang, C.-L., Elkind, M., Rundek, T., Wright, C., & Sacco, R. (2005) · Circulation · doi:10.1161/01.cir.0000157736.19739.d0 · Cited by 769
Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies
Lovett, J. K., Coull, A. J., & Rothwell, P. M. (2004) · Neurology · doi:10.1212/01.wnl.0000110311.09970.83 · Cited by 736
Collaborators, N. M. S. S., Sacco, R. L., Boden-Albala, B. M., Gan, R., Chen, X., Kargman, D. E., Shea, S., Paik, M. C., & Hauser, W. A. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009445 · Cited by 722
Petty, G. W., Brown, R. D., Whisnant, J. P., Sicks, J. D., O’Fallon, W. M., & Wiebers, D. O. (2000) · Stroke · doi:10.1161/01.str.31.5.1062 · Cited by 712
Use of race and ethnicity in biomedical publication
Kaplan, J. B. (2003) · JAMA · doi:10.1001/jama.289.20.2709 · Cited by 609
Cited by
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Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., Fang, M. C., Fisher, M., Furie, K. L., Heck, D. V., et al. (2014) · Stroke · doi:10.1161/str.0000000000000024 · Cited by 5,170
Self-citationKleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., et al. (2021) · Stroke · doi:10.1161/str.0000000000000375 · Cited by 3,237
Forecasting the Future of Stroke in the United States
Ovbiagele, B. I., Goldstein, L. B., Higashida, R. T., Howard, V. J., Johnston, S. C., Khavjou, O., Lackland, D. T., Lichtman, J. H., Mohl, S., Sacco, R. L., et al. (2013) · Stroke · doi:10.1161/str.0b013e31829734f2 · Cited by 834
Racial-Ethnic Disparities in Stroke Care: The American Experience
Cruz‐Flores, S., Rabinstein, A. A., Biller, J., Elkind, M. S. V., Griffith, P. A., Gorelick, P. B., Howard, G., Leira, E. C. C., Morgenstern, L. B., Ovbiagele, B. I., et al. (2011) · Stroke · doi:10.1161/str.0b013e3182213e24 · Cited by 525
Self-citationStroke Epidemiology: Advancing Our Understanding of Disease Mechanism and Therapy
Ovbiagele, B. I., & Nguyen‐Huynh, M. N. (2011) · Neurotherapeutics · doi:10.1007/s13311-011-0053-1 · Cited by 460
Metadata
- Authors
- Schwamm, L. H., Reeves, M. J., Pan, W., Smith, E. E., Frankel, M. R., Olson, D., Zhao, X., Peterson, E., & Fonarow, G. C.
- Affiliations
- Emory University (US)
- ORCID
- Venue
- Circulation
- Published
- 2010-04-06
- Volume
- 121
- Issue
- 13
- Pages
- 1492-1501
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2074386052
- Cited by
- 292
- References
- 42
- Citations by year
- 2026: 8 · 2025: 21 · 2024: 29 · 2023: 26 · 2022: 17 · 2021: 19 · 2020: 10 · 2019: 11 · 2018: 8 · 2017: 18 · 2016: 19 · 2015: 20 · 2014: 17 · 2013: 23 · 2012: 13
- FWCI
- 15.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Pfizer
- American Stroke Association
- Centers for Disease Control and Prevention
- National Institute of Neurological Disorders and Stroke
- Topics
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- ischemic stroke, racial disparities, ethnic disparities, quality of care, Black patients, Hispanic patients, Caucasian patients, intravenous thrombolysis, deep vein thrombosis prevention, smoking cessation, antithrombotic therapy, atrial fibrillation anticoagulation, lipid therapy, in-hospital mortality, length of hospital stay, Get With The Guidelines-Stroke, evidence-based care
- MeSH terms
- Aged, Aged, 80 and over, Black or African American, Brain Ischemia, Female, Hispanic or Latino, Humans, Male, Middle Aged, Quality of Health Care, Registries, Risk Factors, United States, Thrombolytic Therapy, Hospital Mortality, Stroke, Black People, White People, Racial Groups
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