Objective:

To examine racial disparities among patients with embolic stroke treated at a large academic medical center located in a majority-minority region.

Background:

Multiple published studies have revealed that white patients with embolic stroke are more likely to receive thrombolysis and undergo mechanical thrombectomy (MT) than non-white patients. Similarly, some reports describe racial disparities with regard to accessible stroke care, time from symptom onset to presentation, and functional outcomes. We investigated whether similar gaps exist among patients treated at a large academic medical center located in a majority-minority region.

Design/Methods:

We retrospectively reviewed electronic records of all patients from 2012-2021 at our institution who underwent thrombectomy for embolic stroke. We collected demographics; times of symptom onset, hospital arrival, and recanalization; rates of thrombolytic administration; and NIHSS, modified treatment in cerebral infarction (mTICI) and 90-day modified Rankin (mRS) scores. Results were analyzed using ꭓ2 and t-tests.

Results:

708 patients were included; Black (n=262, 37%), non-Black (n=446, 63%). Mean times from symptom onset to hospital arrival were 354 and 380 minutes, respectively [p=0.261]. Mean times from hospital arrival to recanalization were 168 and 130 minutes, [p=0.0026]. Mean times from symptom onset to recanalization were 472 and 507 minutes, [p=0.752]. 45% of Black and 42% of non-Black patients received thrombolysis [p=0.348]. No significant differences were observed among NIH stroke scale, mTICI and 90-day mRS scores [p=0.45, 0.958, 0.971].

Conclusions:

Among patients with embolic stroke treated at a large academic medical center located in a majority-minority region, mean times from symptom onset to arrival, mTICI, and mRS were comparable between populations, but times from arrival to recanalization were significantly longer among Black than non-Black patients. Further study is needed to uncover reasons for this disparity and to evaluate impacts on stroke outcomes.