Abstract WP239: Ethnic Differences in Multiple Chronic Conditions Among Ischemic Stroke Patients From the Brain Attack Surveillance in Corpus Christi Project

Abstract

Introduction: The risk of developing multiple chronic conditions (MCC) increases with age. MCC predicts stroke outcomes and impairs prestroke reserve that aids the neuropsychological process of stroke recovery. Mexican Americans (MAs) have increased stroke risk, worse stroke outcomes and a different profile of pre-stroke comorbidities compared to non-Hispanic whites (NHWs). We assessed ethnic differences in the overall burden of MCC among ischemic stroke patients from a bi-ethnic, population-based stroke study. Methods: We studied patients with ischemic stroke between November 2008 and March 2017. Twenty-two chronic conditions (prevalence 1%-83%) were identified from medical records and ICD-9 and 10 codes from hospital discharge data. MCC burden was measured by the total number of chronic conditions. Ethnic differences in terms of the odds of experiencing none (<2 conditions), low MCC (2-3 conditions), or high MCC (>4 conditions) were assessed using a proportional odds model adjusting for age (at stroke onset). Effect modification by age was also investigated. Results: Of 1,656 stroke patients, 68% were MA, 51% were female, mean age was 69 (SD=13), median number of MCC was 4 (IQR: 2-6). MAs were younger at stroke onset, but more likely to have higher age-adjusted MCC burden (OR 1.32, 95% CI: 1.07-1.62) compared to NHWs. The difference in MCC burden was modified by age (p= 0.02), with greater ethnic difference in MCC burden among younger patients (Figure). Conclusion: MAs have greater MCC burden at stroke onset compared to NHWs, especially in younger patients. The contribution of this ethnic difference in MCC burden to ethnic disparities in stroke outcome needs further investigation.