DOI: 10.1161/str.55.suppl_1.79 ISSN: 0039-2499

Abstract 79: Twelve-Year Trends in Ninety-Day Stroke Outcomes and Ethnic Differences From a Population-Based Study

Lynda D Lisabeth, Madeline Kwicklis, Melinda Cox, Erin CASE, Lewis B Morgenstern
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)

Background: Stroke outcomes may be changing over time with improved acute stroke therapy, secondary prevention, and post-acute care. At the same time, stroke mortality has declined suggesting more people are living with stroke disability. No US population-based data exists on trends in outcomes. The objective was to investigate trends and ethnic differences in 90-day stroke outcomes in a population-based study.

Methods: First-ever ischemic strokes in the population-based Brain Attack Surveillance in Corpus Christi Project (2009-2020, n=1,449) were included. 90-day outcomes included function (activities of daily living (ADL)/instrumental ADL), cognition (modified mini-mental state exam), NIHSS, and quality of life (Stroke-Specific Quality of Life (SS-QoL)). Linear regression with multiple imputation and inverse probability weighting was used to model adjusted associations between time, ethnicity, the interaction of time and ethnicity and outcomes.

Results: Median age was 66; 61% Mexican American (MA). Trends in 90-day function overtime were roughly quadratic (Figure) and the change in the ethnic difference was significant among reference groups (p-value&lt0.01). Trends in NIHSS were linear with no change in the ethnic difference (p-value=0.51). Trends in cognition were approximately cubic and the change in the ethnic difference was significant within reference groups (p-value=0.03). Trends in QOL were stable with no change in the ethnic difference.

Conclusion: Recent improvements in 90-day post-stroke functional and cognitive outcomes in MAs have resulted in reduced disparities. Factors contributing to favorable trends in outcomes in this group should be further studied.

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