Socioeconomic Disparities in the Utilization of Mechanical Thrombectomy for Acute Ischemic Stroke

Background Previous studies have demonstrated that socioeconomic disparities in access to treatment of cerebrovascular diseases exist. We studied the Nationwide Inpatient Sample (NIS) to determine if disparities exist in utilization of mechanical thrombectomy for acute ischemic stroke. Methods Using...

Full description

Saved in:
Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2014-05, Vol.23 (5), p.979-984
Main Authors: Brinjikji, Waleed, MD, Rabinstein, Alejandro A., MD, Cloft, Harry J., MD, PhD
Format: Article
Language:English
Subjects:
acute ischemic stroke
Brain Ischemia - diagnosis
Brain Ischemia - economics
Brain Ischemia - ethnology
Brain Ischemia - therapy
Cardiovascular
Chi-Square Distribution
Continental Population Groups
epidemiology
Ethnic Groups
Health Services Accessibility - economics
Healthcare Disparities - economics
Healthcare Disparities - ethnology
Humans
Income
Insurance Coverage - economics
Insurance, Health - economics
Logistic Models
Mechanical thrombectomy
Multivariate Analysis
Neurology
Odds Ratio
Practice Patterns, Physicians' - economics
Risk Factors
Socioeconomic Factors
socioeconomics
Stroke - diagnosis
Stroke - economics
Stroke - ethnology
Stroke - therapy
Thrombectomy - economics
Thrombectomy - utilization
Treatment Outcome
United States - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Previous studies have demonstrated that socioeconomic disparities in access to treatment of cerebrovascular diseases exist. We studied the Nationwide Inpatient Sample (NIS) to determine if disparities exist in utilization of mechanical thrombectomy for acute ischemic stroke. Methods Using the NIS for the years 2006-2010, we selected all discharges with a primary diagnosis of acute ischemic stroke. Patients who received mechanical thrombectomy for stroke were identified by using the International Classification of Diseases, Ninth Revision, procedure code 39.74. We examined the utilization rates of mechanical thrombectomy by race/ethnicity (white, black, Hispanic, and Asian/Pacific Islander), income quartile (first, second to third, and fourth), and insurance status (Medicare, Medicaid, self-pay, and private). We also studied thrombectomy utilization rates at hospitals that performed thrombectomy. Results From 2006 to 2010, 2,087,017 patients were hospitalized with a primary diagnosis of acute ischemic stroke; 8946 patients (.4%) received mechanical thrombectomy. Compared with white patients, black patients had significantly lower rates of overall mechanical thrombectomy utilization (odds ratio [OR] = .59, 95% confidence interval [CI] = .55-.64, P  
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2013.08.008