February 1, 2011

Blacks More Likely to Survive Stroke

(Ivanhoe Newswire) -- A new study reveals African Americans have a better survival rate compared to whites after being hospitalized for a stroke.

Researchers found that the survival advantage was most pronounced early after the stroke but lasted for up to a year. They also found African Americans were more likely to receive aggressive treatment measures, such as kidney dialysis, a tracheostomy, or cardiopulmonary resuscitation, during their hospitalization.

"These results fly in the face of conventional wisdom that says that black patients with strokes have worse outcomes," Robert Holloway, M.D., M.P.H., a neurologist from the University of Rochester Medical Center (URMC), was quoted as saying. "Even though we do not know the exact reasons for these differences, these data highlight the potential importance of treatment intensity, and the expression of patient preference for different treatments on survival and mortality. This is not such a far-fetched idea for physicians who take care of a lot of stroke patients."

For the study, researchers used data from the New York State Statewide Planning and Research Cooperative System -- a reporting system that collects detailed information on every hospital and emergency department admission in the state. They compiled data for all African American and white patients aged 18 and older who were admitted to the hospital with a diagnosis of acute ischemic stroke between 2005 and 2006. The investigators looked at death rates for several incremental periods beginning at seven days and up to a year after the stroke. They also looked at what life-sustaining interventions the patients received while being hospitalized.

"Although we don't show any causal relationship, the association of lower risk of death and increased use of life-sustaining interventions is actually very consistent with the idea that preference sensitive end-of-life care may have an important impact on short-term mortality," Holloway said. "We were unable to measure health or quality of life in those patients who survived, which is a critically important question. We also need much more research on ways to measure the quality of the decision process itself to make sure that the treatments patients receive are consistent with their underlying values and preferences."

SOURCE: Annals of Internal Medicine, Jan. 31, 2011