急性和住院中风患者护理的各种社会人口学变量。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-05-17 DOI:10.1016/j.jstrokecerebrovasdis.2025.108350

Glenn Goodwin DO , Henry Yelkin DO , McHenry Mauger MS , David Filippi MD , Ayah Badawy , Jonghoon Chang MS , Benjamin Leicht DO , Erin Marra MD

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引用次数: 0

摘要

背景：影响脑卒中结局的关键因素包括快速诊断和早期治疗，然而，症状识别的差异，特别是在少数群体中，影响及时护理。本研究考察了患者特征对卒中指标的影响，重点是年龄、性别、民族、种族、保险状况和语言偏好等因素。方法：利用美国国家医院公司（HCA）数据库进行多中心回顾性研究，分析2017年至2022年170家HCA医院的37,956例急性缺血性卒中（AIS）病例。我们评估了人口统计学和患者特异性因素对tPA给药率、tPA时间（TtPA）和住院时间（LOS）的影响。统计方法包括优势比、单因素方差分析、混合效应模型和负二项回归。结果：影响tPA给药的因素包括年龄、性别和保险状况。年龄在45岁及以上的患者以及接受医疗补助或医疗保险的患者接受tPA的可能性较小。NIH脑卒中量表（NIHSS）评分显著影响tPA给药率和TtPA。语言偏好不影响tPA给药率或tPA，但非英语使用者的住院时间更长。西班牙裔和黑人患者的LOS也分别比非西班牙裔和白人患者长。结论：本研究强调需要有针对性的干预措施来解决卒中管理和结果的差异。未来的研究应该探索这些差异的潜在原因，并制定策略来提高不同患者群体的卒中护理公平性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Various sociodemographic variables on acute and inpatient stroke care

Background

Key factors affecting stroke outcomes include swift diagnosis and early treatment, however, disparities in symptom recognition, particularly in minority groups, impact timely care. This study examines the influence of patient characteristics on stroke metrics, focusing on factors such as age, sex, ethnicity, race, insurance status, and language preference.

Methods

We conducted a multicenter, retrospective study using the National Hospital Corporation of America (HCA) database, analyzing 37,956 acute ischemic stroke (AIS) cases from 170 HCA hospitals between 2017 and 2022. We evaluated the impact of demographic and patient-specific factors on tPA administration rates, time-to-tPA (TtPA), and hospital length of stay (LOS). Statistical methods included odds ratios, one-way ANOVA, mixed-effects models, and negative binomial regression.

Results

Factors affecting tPA administration included age, sex, and insurance status. Patients aged 45 and older and those with Medicaid or Medicare were less likely to receive tPA. NIH Stroke Scale (NIHSS) scores significantly influenced tPA administration rates and TtPA. Language preference did not impact tPA administration rates or TtPa, but non-English speakers experienced longer hospital stays. Hispanic and Black patients also had longer LOS compared to non-Hispanic and White patients, respectively.

Conclusion

This study underscores the need for targeted interventions to address disparities in stroke management and outcomes. Future research should explore the underlying causes of these differences and develop strategies to enhance stroke care equity across diverse patient populations.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.