Abstract TP2: Disparities in Delivery of Endovascular Therapy: Who Gets it and Where? The Florida Puerto Rico Collaboration to Reduce Stroke Disparities Study

• DOI: 10.1161/str.48.suppl_1.tp2
• Publication Date: 2021-06-21T16:59:15Z
• Authors: Negar Asdaghi; Lais Granzoti Cintra; Kefeng Wang; Maria A Ciliberti...; Sebastian Koch; Hannah Gardener; Chuanhui Dong; Erika Marulanda-L...; David Z Rose; Salina P Waddy; Nils Mueller-Kronast; Mary Robichaux; Dianne Foster; Enid J Garcia; Tatjana Rundek; Ralph L Sacco; Jose G Romano
• Keywords: Stroke

Background and Purpose: Endovascular thrombectomy improves functional outcome in select ischemic stroke patients. In the NINDS-funded CReSD Registry we sought to determine clinical, hospital regional characteristics associated with use of this therapy patients presenting acute stroke. Methods: Ischemic within 24 hours onset were prospectively included from 82 sites Florida Puerto Rico January 2010 April 2016. Independent predictors endovascular evaluated using multivariable logistic regression generalized estimating equations. Results: Among 58,204 (50% male, 65% white, 15% black, 20% Hispanic, mean age±SD 71±14 yrs), 2105 (3.6%) received (50.9% men, 62.3% 13.7% 24% 70±15yrs) (35.2%) or without intravenous thrombolysis. Patients who had a significantly lower risk vascular factors except for Afib (33.7% vs 19.0%), more severe strokes (median NIHSS 15 vs. 5) likely arrive quickly (126 min 210 min), via EMS (70.4% 59.6%) as transfer another (20.8% 5.8%,) during working (47.7% 45.6%), large hospitals (≥ 680 beds) (48.3% 28.8%), treated South (47.3% 35.9%) compared those not receiving treatment. analysis; age (OR 0.97, 95% CI 0.96- 0.98), Blacks 0.68, 0.56-2.28) White, off-hour presentation 0.76, 0.66- 0.96), regions other than (North OR 0.40, 0.17-0.93, Panhandle 0.12, 0.04-0.36) remained independently therapy. contrast, Hispanics 1.28, 1.03- 1.69) White 4.92, 1.05- 22.6) higher Conclusions: There are significant race, disparities delivery care. Efforts should me made improve access treatment across region all centers.