墨西哥裔美国人和非西班牙裔白人脑卒中质量测量。

Darin B Zahuranec, Lynda D Lisabeth, Jonggyu Baek, Eric E Adelman, Nelda M Garcia, Erin C Case, Morgan S Campbell, Lewis B Morgenstern
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引用次数: 0

摘要

墨西哥裔美国人(MAs)卒中后的预后比非西班牙裔白人(NHWs)差,但尚不清楚卒中护理质量的种族差异是否会导致这些较差的预后。在科珀斯克里斯蒂(BASIC)项目(2009年2月- 2012年6月)基于人群的前瞻性脑梗死监测中,我们调查了MAs和NHWs住院脑卒中护理质量的种族差异。根据2008年联合委员会初级卒中中心定义,住院患者卒中护理的质量指标由训练有素的摘要人员从医疗记录中进行评估。还创建了两个总体质量的总结测量(无缺陷护理的二元测量和患者符合条件的测量比例)。共纳入757人(480名ma和277名NHWs)。MAs比NHWs更年轻,更容易患高血压和糖尿病,更不容易患心房颤动。ma患者接受tPA治疗的可能性低于nhw患者(RR: 0.72, 95%可信区间(CI) 0.52, 0.98), ma患者在出院时接受抗凝药物治疗的可能性低于nhw患者(RR 0.73, 95% CI 0.58, 0.94)。在其他个体质量测量或评估整体质量的两项总结测量中,没有种族差异。综上所述,尽管因房颤而出院时接受tPA和抗凝剂治疗的患者比例存在种族差异,但MAs和NHWs在卒中护理的整体质量上没有种族差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stroke Quality Measures in Mexican Americans and Non-Hispanic Whites.

Mexican Americans (MAs) have been shown to have worse outcomes after stroke than non-Hispanic Whites (NHWs), but it is unknown if ethnic differences in stroke quality of care may contribute to these worse outcomes. We investigated ethnic differences in the quality of inpatient stroke care between MAs and NHWs within the population-based prospective Brain Attack Surveillance in Corpus Christi (BASIC) Project (February 2009- June 2012). Quality measures for inpatient stroke care, based on the 2008 Joint Commission Primary Stroke Center definitions were assessed from the medical record by a trained abstractor. Two summary measure of overall quality were also created (binary measure of defect-free care and the proportion of measures achieved for which the patient was eligible). 757 individuals were included (480 MAs and 277 NHWs). MAs were younger, more likely to have hypertension and diabetes, and less likely to have atrial fibrillation than NHWs. MAs were less likely than NHWs to receive tPA (RR: 0.72, 95% confidence interval (CI) 0.52, 0.98), and MAs with atrial fibrillation were less likely to receive anticoagulant medications at discharge than NHWs (RR 0.73, 95% CI 0.58, 0.94). There were no ethnic differences in the other individual quality measures, or in the two summary measures assessing overall quality. In conclusion, there were no ethnic differences in the overall quality of stroke care between MAs and NHWs, though ethnic differences were seen in the proportion of patients who received tPA and anticoagulant at discharge for atrial fibrillation.

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