Evaluating Reasons for Racial Differences
in Mortality from Stroke

Racial and ethnic disparities in the burden of stroke pose a critical research question and treatment challenge. Blacks not only have an increased incidence of strokes compared to whites, they also have worse functional outcomes and have been reported to have higher case-fatality after both ischemic and hemorrhagic stroke . Reasons for the worse outcomes after stroke in blacks are unclear. Differences in degree of neurological impairment and hospital management are two potential explanatory factors, although there are surprisingly sparse and conflicting data about each. Understanding the racial differences in these two areas are important first steps to reducing racial disparities in outcomes after stroke. Funded by the American Heart Association, SORP researchers are performing a study of this subject with the following specific aims:

1. Determine racial differences in the degree of neurological impairment of stroke patients as defined by the National Institutes of Health Stroke Scale score (NIHSS)
2. Compare the use of in-hospital diagnostic tests, process of care measures (involving routine hospital care and secondary prevention medications), and therapeutic interventions between blacks and matched whites with similar medical acuity as defined by predicted 30-day mortality
3. Compare the occurrence of hospital complications between blacks and matched whites after adjusting for neurological impairment, comorbidity (Charlson Index), and overall acute clinical stability as defined by predicted 30-day mortality on admission.

The community-based stroke management abstraction team, who are also working on the PneumoniaStudy, is collecting data for this study.

Members of the Community-based stroke management abstraction team (left to right): Nancy Konrad RN, Siobhan Martin ND, Katherine Haas RN, Miriam Palmer CRC.