Abstract 18919: Race/Ethnic Differences in Mortality Among Patients Hospitalized with Intracerebral Hemorrhage

Abstract

Background: Despite higher burden of stroke in minorities, limited data exists in comparing mortality for patients with intracerebral hemorrhage of different racial and ethnic background.

Methods: Data from 123,736 patients (83,280 white, 22,165 black, 10,541 Hispanic, and 7,750 other race) with intracerebral hemorrhage admitted to 1,199 Get With The Guidelines-Stroke hospitals between 2003 and 2012. Multivariate logistic regressions with generalized estimating equations were performed to evaluate the association between race and in-hospital mortality.

Results: Compared with white patients, black, other race, and Hispanic patients were younger (median 75, 59, 67, and 64), had less comorbidities except for diabetes mellitus and hypertension, and had more severe stroke (National Institutes of Health Stroke Scale [NIHSS], median 9, 10, 11, and 10; all p<0.001). Black (23.0%, adjusted OR 0.91, 95% CI 0.87-0.95), Hispanic (22.8%, adjusted OR 0.85, 95% CI 0.79-0.91), and other racial/ethnic patients (25.3%, adjusted OR 0.87, 95% CI 0.81-0.93) were less likely to die in hospital than white patients (27.6%) after adjustment for patient and hospital characteristics. The mortality differences remained consistent after further adjustment for NIHSS in NIHSS complete records (N=47,436). To determine whether race/ethnic differences in mortality varied by age, we examined the interaction between race and age (p <0.009). The survival advantage was observed in older age groups but was not evident in younger age groups (Table). In contrast to lower mortality, minorities had longer length of stay than white patients (median 6, 6, 6, and 5 days for black, Hispanic, other, and white respectively, p<0.001).

Conclusion: Among patients hospitalized with intracerebral hemorrhage, black, Hispanic, and other race/ethnic groups have lower risk of in-hospital mortality compared to white patients, though these race/ethnic differences were confined to patients age 60 and older.