Abstract TP205: Higher Vascular Risk and Poorer Outcomes in Young Black and Hispanic Stroke Patients

Abstract

Introduction: Recent studies show rising incidence of stroke in the young, for which risk factors are not well characterized. There is evidence of increased risk in certain race and ethnic groups. We sought to assess racial differences in risk factors, stroke etiology, and outcomes among young stroke patients. Methods: Using data from our inpatient registry for ischemic stroke, we reviewed patients aged 18-50 who were admitted 01/2013 to 04/2018. Race/ethnicity were characterized as non-Hispanic White (NHW), non-Hispanic Black(NHB), Hispanic(HIS) and other groups were excluded given small numbers (<6%). For univariate comparisons chi-square, ANOVA and Kruskal-Wallis tests were performed as appropriate. Multivariate logistic regression was used to assess impact of race on day 7 modified Rankin score (mRS) . Results: Among 862 patients admitted in the study period, mean age was 40.9 (SD 7.8), 57.3% were male, and 36.4% NHW, 42.8% NHB, 20.8% HIS. History of hypertension (HTN), type II diabetes (DM II), smoking, heart failure (CHF), prior stroke, end stage renal disease, and triglycerides varied significantly by race (Table 1). Compared to NHW, NHB had higher odds of HTN (OR 2.2, CI 1.6-3.0), CHF (OR 2.3, CI 1.1-4.6), and DMII (OR 1.81, CI 1.2-2.7) while HIS had higher odds of DMII (OR 2.26, CI 1.4-3.6) and lower odds of smoking (OR 0.5, 0.3-0.8). Arrival NIHSS was higher in NHB, but etiology and rates of tpA treatment and thrombectomy did not vary by race. Compared to NHW patients, NHB (OR 0.5, CI 0.3-0.9 ) and HIS (OR 0.4 CI 0.2-0.9) were less likely to have good functional outcome (mRS <2) at day 7 in adjusted analyses. Conclusions: In this study, there was a higher prevalence of several modifiable risk factors in NHB and HIS young stroke patients and early functional outcome was worse in these groups. This suggests a need for targeted prevention efforts for younger populations at highest risk. The findings regarding outcomes deserve further study.