Abstract HUP15: Investigating Racial Disparities In Acute Stroke Management At An Academic Comprehensive Stroke Center

Abstract

Introduction: In the U.S. racial disparities in age of diagnosis and outcome of ischemic stroke remain despite advances in preventive, acute and chronic management. Social determinants of health, implicit bias and lack of diversity in healthcare which are resultant of systems of oppression have been identified as root causes. It is currently understood that primordial factors such as relatively higher risk of vascular disease, limited access and low stroke literacy contribute to these discrepancies. The role of delivery of care in the acute stroke setting has, however, not yet been investigated. Objectives: In this retrospective study we sought to elucidate if significant delays in acute stroke care exist in non-white (NW) compared to white (W) patients at Wake Forest Baptist. Methods: Data from EPIC of patients hospitalized from January 2018 to December 2019 were pulled via the Comprehensive Stroke Center and Get with the Guidelines databases. Standard descriptive statistical analyses were used. Results: We found that time to activation of acute stroke protocol, time to IV thrombolytic administration (NW 42.5 min, W 44.0 min, p= 0.82) and proportion of Individuals with a 90-day modified Rankin Scale score of 0 to 3 (NW 71.4%, W 60.0%, p= 0.24) were comparable. Interestingly and though not statistically significant, we did find that white patients underwent EVT sooner (NW 98 min, W 88 min, p= 0.54) and were more likely to achieve near-complete reperfusion when compared to their non-white counterparts (NW 80.0%, W 92.3%, p= 0.30). Discussion: Within our institution there are no differences in outcome between races of the patients who receive standard acute stroke care, suggesting that the protocolization of this emergent clinical practice may potentially play a role in mitigating racial disparities.