Abstract
Socioeconomic and health inequalities persist in multicultural western countries. Here, we compared outcomes following an acute stroke amongst ethnic minorities with Caucasian patients. Data were prospectively collected (2014-2016) from the Sentinel Stroke National Audit Programme for 3309 patients who were admitted with an acute stroke in four UK hyperacute stroke units. Associations between variables were examined by chi-squared tests and multivariable logistic regression, adjusted for age, sex, prestroke functional limitations and co-morbidities, presented as odds ratios (OR) with 95% CI. There were 3046 Caucasian patients, 95 from ethnic minorities (mostly South Asians, Blacks, mixed race and a few in other ethnic groups) and 168 not stated. Compared with Caucasian patients, those from ethnic minorities had a proportionately higher history of diabetes (33.7% vs 15.4%, P < 0.001), but did not differ in other chronic conditions, functional limitations or sex distribution. Their age of stroke onset was younger both in women (76.8year vs 83.2year, P < 0.001) and in men (69.5year vs 75.9year, P = 0.002). They had greater risk for having a stroke before the median age of 79.5year: OR = 2.15 (1.36-3.40) or in the first age quartile (< 69year): OR = 2.91 (1.86-4.54), requiring palliative care within the first 72h: OR = 3.88 (1.92-7.83), nosocomial pneumonia or urinary tract infection within the first 7daysof admission: OR = 1.86 (1.06-3.28), and in-hospital mortality: OR = 2.50 (1.41-4.44). Compared with Caucasian patients, those from ethnic minorities had earlier onset of an acute stroke by about 5years and a 2- to fourfold increase in many stroke-related adverse outcomes and death.
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