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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Racial and ethnic disparities in the use of intravenous recombinant tissue plasminogen activator and outcomes for acute ischemic stroke
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Racial and ethnic disparities in the use of intravenous recombinant tissue plasminogen activator and outcomes for acute ischemic stroke

机译：静脉使用重组组织纤溶酶原激活剂的种族和种族差异以及急性缺血性卒中的预后

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摘要

Racial and ethnic disparities in acute stroke care in the United States have been previously reported. This study investigated possible racial and ethnic disparities in the administration and outcome of recombinant tissue plasminogen activator (rtPA) therapy for acute ischemic stroke in whites, blacks, Hispanics, and Asian/Pacific Islanders. Using the National Inpatient Sample for 2001-2008, we selected patients with a primary diagnosis of acute ischemic stroke who received treatment with rtPA. Patient data were stratified by race (white, black, Hispanic, and Asian/Pacific Islander). We analyzed the association of patient race on rtPA utilization rate, in-hospital morbidity (ie, discharge to long-term facility), intracranial hemorrhage (ICH) rate, and in-hospital mortality. We performed a multivariate logistic regression analysis to determine independent predictors of poor outcomes. White patients had a higher rate of tPA utilization than black and Hispanic patients (2.3% vs 1.8% and 2.0%, respectively; P < .0001 for both groups). There was no difference in the rate of tPA utilization between whites and Asian/Pacific Islanders (2.3% vs 2.2% P =.07). Multivariate analysis of morbidity, mortality, and ICH rates found that Asian/Pacific Islanders had significantly higher rates of mortality (odds ratio, 1.22, 95% confidence interval, 1.03-1.44; P =.02) and ICH (odds ratio, 2.01; 95% confidence interval, 1.91-2.11; P <.0001) compared with whites. rtPA utilization was greater in white and Asian/Pacific Islander patients than in black and Hispanic patients. Asian/Pacific Islander race was associated with increased risk of ICH and mortality after rtPA administration.
机译：先前已经报道了美国急性中风护理中的种族和种族差异。这项研究调查了针对白人，黑人，西班牙裔和亚洲/太平洋岛民的急性缺血性中风的重组组织纤溶酶原激活剂（rtPA）治疗的给药方法和结果可能存在的种族和种族差异。我们使用2001-2008年的全国住院患者样本，选择了接受rtPA治疗并具有急性缺血性中风的初步诊断的患者。患者数据按种族分类（白人，黑人，西班牙裔和亚洲/太平洋岛民）。我们分析了患者种族与rtPA利用率，院内发病率（即出院至长期设施），颅内出血（ICH）率和院内死亡率之间的关系。我们进行了多元逻辑回归分析，以确定不良预后的独立预测因子。白人患者的tPA利用率高于黑人和西班牙裔患者（分别为2.3％，1.8％和2.0％;两组均P <.0001）。白人和亚洲/太平洋岛民之间的tPA利用率没有差异（2.3％比2.2％P = .07）。对发病率，死亡率和ICH发生率的多因素分析发现，亚洲/太平洋岛民的死亡率（奇数比为1.22，95％置信区间为1.03-1.44; P = .02）和ICH（奇数比为2.01; P = .02）。与白人相比，置信区间为95％，1.91-2.11; P <.0001）。白人和亚洲/太平洋岛民患者的rtPA利用率高于黑人和西班牙裔患者。 rtPA管理后，亚洲/太平洋岛民种族与ICH风险增加和死亡率增加相关。

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