Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers.

Authors

Hugo J. Aparicio, Boston University; University of Pennsylvania
Brendan G. Carr, Thomas Jefferson UniversityFollow
Scott E. Kasner, University of Pennsylvania
Michael J. Kallan, University of Pennsylvania
Karen C. Albright, University of AlabamaFollow
Dawn O. Kleindorfer, University of Cincinnati
Michael T. Mullen, University of PennsylvaniaFollow

Document Type

Article

Publication Date

10-14-2015

Comments

This article has been peer reviewed. It is the author’s final published version in Journal of the American Heart Association

Volume 4, Issue 10, October 2015, Article number e001877.

The published version is available at DOI: 10.1161/JAHA.115.001877. Copyright © Aparicio et al.

Abstract

BACKGROUND: Primary stroke centers (PSCs) utilize more recombinant tissue plasminogen activator (rt-PA) than non-PSCs. The impact of PSCs on racial disparities in rt-PA use is unknown.

METHODS AND RESULTS: We used data from the Nationwide Inpatient Sample from 2004 to 2010, limited to states that publicly reported hospital identity and race. Hospitals certified as PSCs by The Joint Commission were identified. Adults with a diagnosis of ischemic stroke were analyzed. Rt-PA use was defined by the International Classification of Diseases, 9th Revision procedure code 99.10. Discharges (304 152 patients) from 26 states met eligibility criteria, and of these 71.5% were white, 15.0% black, 7.9% Hispanic, and 5.6% other. Overall, 24.7% of white, 27.4% of black, 16.2% of Hispanic, and 29.8% of other patients presented to PSCs. A higher proportion received rt-PA at PSCs than non-PSCs in all race/ethnic groups (white 7.6% versus 2.6%, black 4.8% versus 2.0%, Hispanic 7.1% versus 2.4%, other 7.2% versus 2.5%, all P

CONCLUSIONS: Racial disparities in intravenous rt-PA use were not reduced by presentation to PSCs. Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.

Recommended Citation

Aparicio, Hugo J.; Carr, Brendan G.; Kasner, Scott E.; Kallan, Michael J.; Albright, Karen C.; Kleindorfer, Dawn O.; and Mullen, Michael T., "Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers." (2015). Department of Emergency Medicine Faculty Papers. Paper 48.
https://jdc.jefferson.edu/emfp/48

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

PubMed ID

26467999