Abstract WP302: Ethnic Differences in Midlife Stroke Outcomes

Abstract

Objective: Stroke rates are stable or increasing in midlife. The implication is many years of stroke-related disability, the impact of which may be greater in Mexican Americans (MAs), a sub-group with high stroke rates, earlier onset strokes, and worse outcomes. Our objective was to compare stroke outcomes by ethnicity (MAs vs non-Hispanic whites (NHWs)) in those age <65 years. Methods: Incident ischemic strokes (IS) among those <65 years of age were identified from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project (2008-2015) conducted in south Texas. In-person baseline and 90-day patient interviews were conducted. Outcomes included functional, neurologic, and cognitive outcomes, quality of life (QOL), and depression, which were compared by ethnicity in regression models adjusted for sociodemographics, stroke severity, stroke treatment, risk factors, and pre-stroke factors. Results: Of 609 IS cases with baseline interview, 508 had outcome data (341 MA, 167 NHW). At baseline, MAs had lower levels of education, higher average BMI, and were more likely to have hypertension and diabetes, but were less likely to smoke, than NHWs. At 90 days post-stroke, MAs reported low physical QOL scores, some difficulty with activities of daily living, and a high prevalence of depression (41%). MAs had significantly worse ninety-day outcomes than NHWs in every domain except depression after adjustment for confounders (Table). Conclusion: MAs with midlife stroke had significantly worse outcomes than NHWs. The growing number of midlife stroke survivors will have unique rehabilitation and healthcare resource needs. Particular attention to MA midlife stroke survivors is warranted.