Abstract TP182: Stroke Outcome in Mexican American Immigrants and Non-Immigrants

Abstract

Background/Objective: We studied the association of being born outside of the U.S. (immigrant) or born in the U.S. (non-immigrant) with 90 day post-stroke outcomes in a population-based stroke study in Texas. Methods: Stroke cases from 2008-2016 were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) project. Outcomes among survivors included ADL/IADL score (higher scores worse) for functional assessment, 3MSE (cognition, lower scores worse), and NIHSS Score (neurologic, higher scores worse). Weighted linear regression models were used to assess the effect of immigration status on the outcomes. Analysis was completed using multiple imputation and inverse probability weighting to account for differential attrition. Results: Of 935 Mexican Americans available for analysis, 83 were immigrants and 852 were non-immigrants. Immigrants had resided in the U.S. on average 47 years. Immigrants were significantly older (69 vs. 66 years), more likely male (60% vs. 49%), more likely to have atrial fibrillation and have less education than non-immigrants (all p<0.05). No differences in hypertension, diabetes, cholesterol, insurance, smoking or other comorbidities existed. The Table provides the data from the fully adjusted models. Immigrants had better functional outcome (mean difference (MD) = -0.22; p=0.02), and no difference for neurologic outcome (MD= -0.15; p=0.15). There was an association of worse cognitive outcome in immigrants (MD= -5.25; p=0.009), however, the association was explained by attenuated after the adjustment for the lower educational attainment in immigrants (MD= -0.79; p=0.64). Conclusions: In this community, there was no evidence of worse stroke outcome among Mexican American immigrants, who had lived in the U.S. for decades, compared with non-immigrants. Further studies of more recent immigrant populations are warranted.