Abstract 12099: The Racial Disparity Among the Clinical Outcomes Post Stroke and Its Intervention Outcomes: A Systematic Review and Meta-Analysis

Background: The Racial disparity between the clinical outcomes post-stroke has not been well studied, with limited literature available.Objective: We conducted a meta-analysis to evaluate the post-stroke outcomes among White and Black patients.

Methods: We systematically searched all electronic databases from inception until 1st March 2023. The primary endpoint was post-stroke in-hospital mortality and all-cause mortality. Secondary endpoints were post-stroke intervention in-hospital mortality, intracerebral hemorrhage, and all-cause mortality (ACM).

Result: 1250397 patients were included in the analysis, with 1018892 (81.48%) patients of the White race and 231505 (18.51%) patients of the Black race. The mean age of the patients in each group was (73.55 vs 66.28). The most common comorbidity among White and Black patients was HTN (73.92% vs 81.00%) and DM (29.37% vs 43.36%). The odds of in-hospital mortality post-stroke (OR, 1.45(95%CI:1.35-1.55), P<0.001), and all-cause mortality (OR, 1.40(95%CI:1.28-1.54), P<0.001) were significantly higher among White patients compared with Black patients. Among patients with post-stroke intervention, the odds of in-hospital mortality (OR, 1.29 (95% CI: 1.05-1.59, P=0.02), and intracerebral hemorrhage(ICH) (OR, 1.15, (95%CI:1.06-1.26), P<0.01) were significantly higher among White patients compared with Black patients post-intervention. However, all-cause mortality (OR,1.21(95%CI: 0.87-1.68, P=0.25) was comparable between both groups.

Conclusion: Our study is the most comprehensive and first meta-analysis with the largest sample size thus far, highlighting that White patients are at increased risk of mortality and post-intervention intracerebral hemorrhage compared with Black patients.