Minority stroke patients are more likely than others to undergo life-sustaining procedures, researchers find, but less likely to receive curative interventions.
Minorities are less likely to receive "curative" stroke care than white patients, but are more likely to receive "life-sustaining procedures," according to a study from the John Hopkins University School of Medicine published in JAMA Neurology.
The researchers compared racial disparities in the delivery of procedures considered curative treatments, those "aiming at improving functional status," such as the use of blood thinners or "intravenous thrombolysis."
The use of carotid revascularization, angioplasty of the carotid artery to prevent future strokes, was also evaluated.
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Researchers also looked at disparities in what they consider "life-sustaining" procedures aimed at preventing death, such as mechanical ventilation and hemicraniectomy to relieve pressure on the brain. In addition, the study covered the use of feeding tubes and tracheostomy to open airways.
Minority patients were more likely than others to undergo life-sustaining procedures than white patients. The odds of receiving a feeding tube were 56% higher. Minorities were also 36% more likely to undergo tracheostomy.
They were, however, 20% less likely undergo intravenous thrombolysis and 43% less likely to receive carotid revascularization, both considered curative interventions.
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The researchers note that their finding have limitations: "These results persisted after accounting for severity of medical comorbidities, end-of-life care, and in-hospital mortality, but we acknowledge that certain clinical characteristics not captured in the Nationwide Inpatient Sample, such as stroke severity, stroke location, and time to presentation, may partially explain our results. "
They suggest that an examination of the "commonalities within and differences between" the procedures may lead to "the development of effective strategies aimed at eliminating racial disparities in the delivery of stroke care."