Racial Disparities in Comorbidities, Acute Care, and Follow-up Among Young Adults with Ischemic Stroke
Seongjoon Won1, Marcus Milani1, Andrew Metz1, Daniel Mansour1, Shahraz Qamar1, Solmaz Ramezani Hashtjin2, Omair Ul Haq Lodhi3, Haitham Hussein1
1University of Minnesota Medical School, 2University of Nebraska Medical Center, 3UTHealth Houston McGovern Medical School
Objective:
This study aimed to identify racial disparities, acute care efficiency, and long-term follow-up among young adults with ischemic stroke.
Background:
The incidence of ischemic stroke in young adults (<45 years) is rising globally, accompanied by an increasing burden of vascular risk factors. Of note, young patients demonstrate different risk profiles compared to their older counterparts, including increased rates of cryptogenic stroke. However, limited data exist regarding racial disparities in the management and outcomes of this population.
Design/Methods:
We conducted a retrospective chart review of 97 patients (67 white, 30 non-white), aged 18-45 with ischemic stroke. Descriptive statistics were used to summarize patient demographics, comorbidities, acute care metrics, and follow-up data. Statistical analysis (Welch’s t-test for continuous variables, chi-square for categorical; significance p<0.05) was performed using Python's Pandas and Scipy libraries.
Results:
Non-white patients had higher rates of heart failure (20% vs. 4.5%, p<0.05), longer door-in-door-out times (183.2 vs. 71.6 minutes, p<0.05), and prolonged hospital stays (7.1 vs. 2.4 days, p<0.05) Furthermore, non-white populations were also less likely to complete follow-up with an outpatient vascular neurology after discharge (40% vs. 68.66%, p < 0.05). Numerically non-white patients were younger (34.10 vs. 37.21, p = 0.056) at presentation. No significant differences were observed in sex distribution, NIHSS score, and hypercoagulability workup.
Conclusions:
Significant racial disparities exist in both acute stroke care and follow up care for young adults with ischemic stroke. Non-white patients had a higher comorbidity burden, experienced critical delays in inter-facility transfer, had longer hospital stays, and were significantly less likely to complete essential outpatient follow-up with a vascular neurologist. These findings highlight specific, modifiable gaps in achieving equitable stroke care.
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