Abstract WP80: Stroke Outcomes Among English And Spanish Speaking Mexican Americans

Abstract

Introduction: We examined if language preference was associated with differences in neurological, functional, and cognitive stroke outcomes among Mexican Americans (MAs). Methods: Ischemic or hemorrhagic stroke patients identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project (2009-2018). Poststroke outcomes at 90 days included neurological [National Institutes of Health Stroke Scale (NIHSS) range 0-44, higher worse], functional [activities of daily living/instrumental activities of daily living (ADL/iADL) range 1-4, higher worse], and cognitive [modified Mini-Mental State Examination (3MSE) range 0-100, lower worse]. Language was determined by which language participant preferred to complete outcome interview in. Differences in stroke outcomes by language were analyzed by weighted Tobit regression. Weights (baseline and outcome interview participation) were created by logistic regression to account for attrition. Age, education, initial NIHSS score, smoking status, BMI, insurance status, sex, and comorbidities were included in weighted Tobit regression models. Results: Of 1,096 patients, 1,001 preferred English and 95 Spanish. Spanish speakers were older (72 versus 66 years; p < 0.01), received less education (p < 0.01), and had higher prevalence of atrial fibrillation (p = 0.02) than English speakers. No other significant differences in baseline demographics or clinical factors were found. In fully adjusted models (Table 1) Spanish speakers had significantly better neurological and functional but worse cognitive outcomes compared with English speakers. Conclusion: This population-based study found better neurologic and functional stroke outcomes among Spanish speaking versus English speaking MAs. The difference in the cognitive outcome may be explained, at least in part, to lack of cultural equivalence of the test instrument. These data suggest further research into the resilience observed among Spanish speakers.