This study was designed to evaluate racial or ethnic disparities in acute telestroke treatments in the TeleSpecialists Telestroke RegistryTM.
Previous studies have shown conflicting evidence of racial and ethnic disparities in acute stroke care, some showing mitigation of differences with telestroke. There have been reports of longer door to needle (DTN) times among racial and ethnic groups, and longer times to neurointerventions have been reported. A large telestroke study to evaluate the potential for telestroke to mitigate racial and ethnic disparities is warranted.
Acute telestroke consultations seen in the emergency department in 375 facilities located in 33 states between January 1, 2024 to December 31, 2024 were extracted from the TeleSpecialists TeleStroke RegistryTM. The variables extracted included demographics, stroke risk factors, and acute stroke metrics. The data was divided into racial groups: White, Black, Asian, Native American, and Hawaiian; and ethnic groups: Hispanic vs Non-Hispanic. The primary analysis compares DTN times and arrival to neurointerventionalists notification (ATN) times between the racial and ethnic groups.
There were 78,417 total cases included in the analysis: White(59,974), Black(13,480), Asian(1,284), Native American(69), Hawaiian(72), Hispanic(7,158) and Non-Hispanic(31,714). There was a significantly shorter ATN time in the White (55 min;(39.0, 54.0)) vs Black (61 min;(45.0, 88.5)) group, p<0.0001, but no significant difference in DTN times. There was no significant difference in DTN and ATN times for White vs other racial groups. The analysis for ethnicity showed significantly shorter DTN time for Non-Hispanic (39 min;(29.0, 53.0)) vs Hispanic (45 min;(32.0, 60.0)), p <0.0001 but no difference in ATN times.
This large telestroke registry found disparities favoring the White, Non-Hispanic population continue to be present. Potential factors including the requirement of interpreters and the impact of the specific vessel occluded are being evaluated currently to look for ways to mitigate these disparities.