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August 6, 2020

Two Studies Evaluate Racial Disparities in Stroke Outcomes, Including in COVID-19 Patients

August 6, 2020—The Society of NeuroInterventional Surgery (SNIS) announced the presentation of findings from two new studies that indicate there are outcome-related racial disparities among patients who experience strokes. The findings were presented at the SNIS 17th annual meeting held virtually August 4-7.

The first study from the North American Neurovascular COVID-19 (NAN-C) Consortium specifically examined stroke patients with COVID-19. The second study is an evaluation of data from SNIS’s NeuroVascular Quality Initiative–Quality Outcomes Database (NVQI-QOD).

The first study, “Ischemic Stroke Associated with COVID-19 and Racial Outcome Disparity in North America,” by Adam A. Dmytriw, MD, et al for the NAN-C Consortium is available online in the SNIS meeting supplement of Journal of NeuroInterventional Surgery.

As reported in the SNIS announcement, the investigators analyzed 69 cases of acute stroke in patients positive for SARS-CoV-2, including 27 African American patients and 42 patients of other racial backgrounds. Dr. Dmytriw and colleagues found that mortality rates in African American stroke patients with COVID-19 were significantly higher than all other races combined in North America. Additionally, the study showed that the mortality rate of COVID-19–positive stroke patients was greater than previously reported in patients who have COVID-19 or stroke alone.

“Clearly it is important to better understand the reasons for increased mortality in African Americans with COVID-19–associated stroke,” commented Dr. Dmytriw in the SNIS press release. “It is our hope that further research will help us reduce racial disparities and prevent negative outcomes.”

The second study, “Racial Disparities in Acute Stroke Thrombectomy Management and Outcomes in the United States: Evidence from the NVQI-QOD Registry,” by Vineeth Thirunavu, et al is also available online in the SNIS supplement to Journal of NeuroInterventional Surgery.

According to SNIS, the study found that minorities exhibited worse immediate postprocedural outcomes and had a greater length of in-hospital and intensive care unit stays. Although African Americans had less in-hospital mortality compared to Caucasians, the odds of increased favorable clinical outcome did not increase.

In this study, the investigators analyzed data from the NVQI-QOD registry and compared racial differences with respect to technical and functional outcomes of stroke thrombectomy in 3,281 African American, Caucasian, Hispanic, and Asian patients in the United States from 23 stroke centers across 17 states between January 2015 and March 2020.

“The study suggests disparities in how African American and Hispanic patients fare with regard to poststroke recovery and hospital course after thrombectomy,” commented the study’s senior investigator Sameer Ansari, MD, in the SNIS announcement. “We are just initiating our investigations and the research potential of the NVQI-QOD registry for uncovering racial disparities in stroke patients, and with this increased knowledge we can strive to ensure better outcomes for all patients, irrespective of their racial and genetic profile.”

Dr. Ansari is Medical Director of the SNIS Patient Safety Organization and an Associate Professor in the Departments of Radiology, Neurology, and Neurological Surgery at Northwestern University Feinberg School of Medicine in Chicago, Illinois.

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