Abstract 49: Withdrawal of Care in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study

Introduction: Withdrawal of care (WOC) during hospitalization is the most common cause of death after intracerebral hemorrhage (ICH). Prior work suggests minority groups are less likely to choose WOC. Our goal was to evaluate for differences in rates of WOC among racial/ethnic groups from the ERICH cohort. Methods: ERICH is an ongoing multicenter study of genetic and environmental risk factors for spontaneous ICH. We analyzed data from the first 725 individuals. Baseline characteristics,do not resuscitate (DNR) status, intensive care procedures, and WOC were prospectively recorded. A central core analyzed all imaging. We compared characteristics among patients with and without eventual WOC and by race/ethnicity. Logistic regression was used to identify variables independently associated with WOC and associations are presented as the odds ratio (95% confidence interval). Results: 9.9% (72/725) of patients underwent WOC. After controlling for age, ICH volume, initial Glasgow Coma Scale (GCS) score, and presence of intraventricular hemorrhage (IVH), there were no significant differences in WOC between non-Hispanic white, non-Hispanic black (OR 1.82; CI 0.78-4.25), and Hispanic (OR 2.16; CI 0.93-5.00) patients. There were also no differences in rates of DNR/DNI status across racial/ethnic groups. In multivariate analysis, patients who underwent WOC had larger ICH volume (1.75; 1.13-2.73); were older (1.43; 1.27-1.61), more likely to have IVH (3.21; 1.53-6.73), and had lower GCS (2.41; 1.63-3.56). While patients who underwent WOC were more likely to have a DNR/DNI order (12.7; 4.69-34.7), intubated patients were more likely to undergo WOC (4.09; 1.08-9.25), even after adjusting for ICH severity. Conclusions: In our cohort, we were able to model ICH severity and factors predictive of WOC. There were not significant racial/ethnic differences in WOC rates. Intubated patients are more likely to undergo care limitations, independent of ICH severity.

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Trastuzumab-induced cardiotoxicity and hypertension among racially and ethnically diverse patients with HER2-positive early-stage breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24092 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24092-e24092

Author(s):

Monica F. Chen ◽

Daniel K. Manson ◽

Ariel Yuan ◽

Katherine D. Crew

Keyword(s):

Breast Cancer ◽

Ethnic Groups ◽

Ethnic Minorities ◽

Early Stage ◽

Early Stage Breast Cancer ◽

Her2 Positive ◽

Factors Associated ◽

Race Ethnicity ◽

Racial Ethnic ◽

Hispanic White

e24092 Background: Trastuzumab improves breast cancer survival but is associated with an increased risk of heart failure. Identifying risk factors associated with trastuzumab induced cardiotoxicity (TIC) would allow for more targeted and intensive screening for at-risk patients. Hypertension is one of the most consistent predictors of TIC. Racial/ethnic minorities are at higher risk of cardiovascular disease but are under-represented in studies of TIC. The objective of this study was to evaluate the relationship between race/ethnicity and risk of TIC among a diverse cohort of patients with HER2-positive early-stage breast cancer. Methods: We conducted a retrospective cohort study of patients treated at Columbia University between 2007 and 2016 for stage I-III breast cancer with adjuvant or neoadjuvant trastuzumab who had at least two echocardiograms. Mild TIC was defined as a ≥10% decline in left ventricular ejection fraction (LVEF); moderate TIC ≥15% decline; severe TIC ≥20% or decline in LVEF to < 50%. Diagnosis of hypertension, average systolic and diastolic blood pressure, and number of hypertension medications was assessed 1- year pre-treatment, during treatment, and 1-year post-treatment. We generated descriptive statistics and used multivariable logistic regression to evaluate demographic and clinical factors associated with TIC. Results: Of 279 patients evaluated, 36.6% were non-Hispanic white, 18.3% non-Hispanic black, 34.8% Hispanic, and 10.4% Asian. The average baseline LVEF was 60% and did not significantly differ between racial/ethnic groups. Mild TIC developed in 33.3% of patients, moderate TIC 18.6%, severe TIC 15.8%, and 14.7% with LVEF decline to < 50%. Patients with hypertension were at increased odds of developing TIC (OR = 2.41, 95% CI = 1.15-3.93; p = 0.02). Prevalence of hypertension was 53% among non-Hispanic white women, 69% non-Hispanic black, 53% Hispanic, and 39% Asian. Incidence of TIC did not differ significantly between racial/ethnic groups. Forty percent of patients with hypertension were not on any medications before initiating trastuzumab. Conclusions: There was no difference in TIC based upon race/ethnicity despite higher rates of hypertension among racial/ethnic minorities compared to non-Hispanic whites. However, a high portion of patients with hypertension were not on any medications before treatment. Increased screening and treatment of hypertension among patients receiving HER2-positive targeted therapy for early-stage breast cancer may be warranted.

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Hispanic Ethnic Density May Be Protective for Older Black/African American and Non-Hispanic White Populations for Some Health Conditions: An Exploration of Support and Neighborhood Mechanisms

Annals of Behavioral Medicine ◽

10.1093/abm/kaab014 ◽

2021 ◽

Author(s):

Melissa Flores ◽

John M Ruiz ◽

Emily A Butler ◽

David A Sbarra

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Social Integration ◽

Ethnic Groups ◽

Indirect Effects ◽

Ethnic Density ◽

Race Ethnicity ◽

Racial Ethnic ◽

Hispanic White ◽

Physical Morbidity

Abstract Background and Purpose Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects. Methods We used Waves 1 (2005–2006), and 2 (2010–2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents’ addresses to a census-tract and overlaid racial–ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial–ethnic categories. Results Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial–ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race–ethnicity. Conclusions This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.

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Race/ethnicity in systemic AL amyloidosis: perspectives on disease and outcome disparities

Blood Cancer Journal ◽

10.1038/s41408-020-00385-0 ◽

2020 ◽

Vol 10 (11) ◽

Author(s):

Andrew Staron ◽

Lawreen H. Connors ◽

Luke Zheng ◽

Gheorghe Doros ◽

Vaishali Sanchorawala

Keyword(s):

Minority Groups ◽

Ethnic Disparities ◽

Sociodemographic Factors ◽

Al Amyloidosis ◽

Advocacy Groups ◽

Disease Characteristics ◽

Race Ethnicity ◽

The Impact ◽

Racial Ethnic ◽

Hispanic White

Abstract In marked contrast to multiple myeloma, racial/ethnic minorities are underrepresented in publications of systemic light-chain (AL) amyloidosis. The impact of race/ethnicity is therefore lacking in the narrative of this disease. To address this gap, we compared disease characteristics, treatments, and outcomes across racial/ethnic groups in a referred cohort of patients with AL amyloidosis from 1990 to 2020. Among 2416 patients, 14% were minorities. Non-Hispanic Blacks (NHBs) comprised 8% and had higher-risk sociodemographic factors. Hispanics comprised 4% and presented with disproportionately more BU stage IIIb cardiac involvement (27% vs. 4–17%). At onset, minority groups were younger in age by 4–6 years. There was indication of more aggressive disease phenotype among NHBs with higher prevalence of difference between involved and uninvolved free light chains >180 mg/L (39% vs. 22–33%, P = 0.044). Receipt of stem cell transplantation was 30% lower in Hispanics compared to non-Hispanic White (NHWs) on account of sociodemographic and physiologic factors. Although the age/sex-adjusted hazard for death among NHBs was 24% higher relative to NHWs (P = 0.020), race/ethnicity itself did not impact survival after controlling for disease severity and treatment variables. These findings highlight the complexities of racial/ethnic disparities in AL amyloidosis. Directed efforts by providers and advocacy groups are needed to expand access to testing and effective treatments within underprivileged communities.

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Race/ethnicity influences outcomes in young adults with supratentorial intracerebral hemorrhage

Neurology ◽

10.1212/wnl.0000000000008930 ◽

2020 ◽

Vol 94 (12) ◽

pp. e1271-e1280

Author(s):

Laura C. Miyares ◽

Guido J. Falcone ◽

Audrey Leasure ◽

Opeolu Adeoye ◽

Fu-Dong Shi ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Functional Outcome ◽

Young Patients ◽

Adult Age ◽

Factors Associated ◽

Poor Outcome ◽

Race Ethnicity ◽

Racial Ethnic ◽

Admission Glasgow Coma Scale ◽

Hispanic White

ObjectivesWe investigated the predictors of functional outcome in young patients enrolled in a multiethnic study of intracerebral hemorrhage (ICH).MethodsThe Ethnic/Racial Variations in Intracerebral Hemorrhage (ERICH) study is a prospective multicenter study of ICH among adult (age ≥18 years) non-Hispanic white, non-Hispanic black, and Hispanic participants. The study recruited 1,000 participants per racial/ethnic group. The present study utilized the subset of ERICH participants aged <50 years with supratentorial ICH. Functional outcome was ascertained using the modified Rankin Scale (mRS) at 3 months. Logistic regression was used to identify factors associated with poor outcome (mRS 4–6), and analyses were compared by race/ethnicity to identify differences across these groups.ResultsOf the 3,000 patients with ICH enrolled in ERICH, 418 were studied (mean age 43 years, 69% male), of whom 48 (12%) were white, 173 (41%) were black, and 197 (47%) were Hispanic. For supratentorial ICH, black participants (odds ratio [OR], 0.42; p = 0.046) and Hispanic participants (OR, 0.34; p = 0.01) had better outcomes than white participants after adjustment for other factors associated with poor outcome: age, baseline disability, admission blood pressure, admission Glasgow Coma Scale score, ICH volume, deep ICH location, and intraventricular extension.ConclusionsIn young patients with supratentorial ICH, black and Hispanic race/ethnicity is associated with better functional outcomes, compared with white race. Additional studies are needed to identify the biological and social mediators of this association.

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Abstract 179: Racial-ethnic Blood Pressure Differences in Acute Intracerebral Hemorrhage.

Stroke ◽

10.1161/str.45.suppl_1.179 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Sebastian Koch ◽

Mitchell S Elkind ◽

Fernando D Testai ◽

Mark W Brown ◽

Sharyl R Martini ◽

...

Keyword(s):

Blood Pressure ◽

Intracerebral Hemorrhage ◽

Group Differences ◽

Baseline Group ◽

Racial Variations ◽

Acute Intracerebral Hemorrhage ◽

Baseline Characteristics ◽

To Receive ◽

Racial Ethnic ◽

Control Study

Background: Intracerebral hemorrhage (ICH) incidence and hypertension prevalence vary among racial-ethnic groups. Elevated blood pressure (BP) is common following ICH, but there are few racial/ethnic comparisons of acute BP. This study assessed the BP response to acute ICH in a multi-ethnic population. Methods: We examined BP in the field (EMS), emergency department (ED) and at 24 hours after ICH in subjects enrolled in the Ethnic Racial Variations of Intracerebral Hemorrhage (ERICH) study. ERICH is a multi-center prospective case-control study of ICH in non-Hispanic whites (whites), non-Hispanic blacks (blacks) and Hispanics. Baseline characteristics and BP recordings by EMS, in the ED and at 24 hours were analyzed for group differences. Results: Of 1052 subjects enrolled, BP recordings were available by EMS in 370, ED in 1041 and at 24 hours in 1014 cases of which 24% were white, 42% black and 34% Hispanic. Whites were significantly older 68± 14 years than blacks (58±13 years) and Hispanics (59± 15 years) (p≤0.0001) and had more lobar hemorrhages (39% vs. 23% blacks and 26% Hispanics; p≤0.0001). Baseline differences included larger hematoma volumes, in whites, and more frequent hypertension history and substance use, including cocaine use and smoking, in blacks. Blacks and Hispanics had significantly higher EMS (p=0.0001) and ED (p=0.0001) systolic BPs compared to whites (blacks: 198± 39, 195± 37; Hispanics: 191± 41, 191± 39; whites: 173± 37, 176± 37 mmHg). At 24 hours blacks had a higher systolic BP (144± 25 mmHg; p=0.0014) than Hispanics and whites (139± 21 and 138± 22 mmHg). These differences remained significant after adjustment for baseline group differences, including lobar and deep location. In multivariate analysis, low GCS and being black were associated with a systolic BP> 140mmHg at 24h. Blacks were more likely to receive BP treatment in the ER when compared to whites and Hispanics (76% vs. 52% and 68%). Conclusion: We found significant differences in the acute BP response to ICH, with blacks and Hispanics having a higher systolic BP at acute presentation. At 24 hours systolic BP remained elevated in blacks. These findings contribute to our understanding of racial-ethnic differences in BP and identify groups at risk for continued BP elevation.

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Racial/Ethnic Differences in Labor Induction in a Contemporary US Cohort: A Retrospective Cohort Study

American Journal of Perinatology ◽

10.1055/s-0037-1607285 ◽

2017 ◽

Vol 35 (04) ◽

pp. 361-368 ◽

Cited By ~ 1

Author(s):

Uma Reddy ◽

Chun-Chih Huang ◽

Rita Driggers ◽

Helain Landy ◽

Katherine Grantz ◽

...

Keyword(s):

Cohort Study ◽

Ethnic Groups ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Labor Induction ◽

Maternal Characteristics ◽

Increased Risk ◽

Race Ethnicity ◽

Racial Ethnic ◽

Hispanic White

Objective To examine labor induction by race/ethnicity and factors associated with disparity in induction. Study Design This is a retrospective cohort study of 143,634 women eligible for induction ≥24 weeks' gestation from 12 clinical centers (2002–2008). Rates of labor induction for each racial/ethnic group were calculated and stratified by gestational age intervals: early preterm (240/7–336/7), late preterm (340/7–366/7), and term (370/7–416/7 weeks). Multivariable logistic regression examined the association between maternal race/ethnicity and induction controlling for maternal characteristics and pregnancy complications. The primary outcome was rate of induction by race/ethnicity. Inductions that were indicated, non-medically indicated, or without recorded indication were also compared. Results Non-Hispanic black (NHB) women had the highest percentage rate of induction, 44.6% (p < 0.001). After adjustment, all racial/ethnic groups had lower odds of induction compared with non-Hispanic white (NHW) women. At term, NHW women had the highest percentage rate (45.4%) of non-medically indicated or induction with no indication (p < 0.001). Conclusion Compared with other racial/ethnic groups, NHW women were more likely to undergo non-medically indicated induction at term. As labor induction may avoid the occurrence of stillbirth, whether this finding explains part of the increased risk of stillbirth for NHB women at term merits further research.

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Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab039 ◽

2021 ◽

Author(s):

Kemar J Brown ◽

Njambi Mathenge ◽

Daniela Crousillat ◽

Jaclyn Pagliaro ◽

Connor Grady ◽

...

Keyword(s):

Statistical Significance ◽

The Elderly ◽

P Value ◽

Chi Square ◽

Cardiovascular Patients ◽

Baseline Characteristics ◽

Racial Ethnic ◽

Cardiovascular Care ◽

Zip Code ◽

Hispanic White

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. Objectives To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods In this single centre retrospective study, all ambulatory cardiovascular encounters occurring between March 16th - June 19th, 2020 were assessed. Baseline characteristics by visit type (in-person, TM-phone, TM-video) were compared using Chi-square and student t-tests, with statistical significance defined by p value < 0.05. Multivariate logistic regression was used to explore the predictors of TM versus in-person care. Results 8446 patients (86% Non-Hispanic White, 42% female, median age 66.8 +/- 15.2 years) completed an ambulatory cardiovascular visit during the study period. TM-phone (n = 4,981, 61.5%) was the primary mode of ambulatory care followed by TM-video (n = 2693, 33.2%). Non-Hispanic Black race (OR 0.56; 95% CI: 0.35 - 0.94, p-value=0.02), Hispanic ethnicity (OR 0.53; 95% CI: 0.29 - 0.98, p = 0.04), public insurance (Medicaid OR 0.50; 95% CI:0.32 – 0.79, p = 0.003, Medicare OR 0.65; 95% CI: 0.47– 0.89, p = 0.009), zip-code linked median household income (MHI) of <$75,000, age >85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM-video encounters and a higher likelihood of in-person care. Conclusions Significant disparities in TM-video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.

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Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz022 ◽

2019 ◽

Vol 6 (2) ◽

Cited By ~ 1

Author(s):

Priya Bhagwat ◽

Shashi N Kapadia ◽

Heather J Ribaudo ◽

Roy M Gulick ◽

Judith S Currier

Keyword(s):

Antiretroviral Therapy ◽

Adverse Events ◽

Socioeconomic Factors ◽

Ethnic Groups ◽

Virologic Failure ◽

Virologic Suppression ◽

Factors Associated ◽

Race Ethnicity ◽

The Impact ◽

Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

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Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

10.2196/preprints.33637 ◽

2021 ◽

Author(s):

Ruby Castilla-Puentes ◽

Jacqueline Pesa ◽

Caroline Brethenoux ◽

Patrick Furey ◽

Liliana Gil Valletta ◽

...

Keyword(s):

Health Belief Model ◽

Ethnic Groups ◽

Ethnic Differences ◽

Health Belief ◽

Depression Symptoms ◽

Seeking Help ◽

Key Drivers ◽

Race Ethnicity ◽

Belief Model ◽

Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

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Abstract TP188: Location of Intracerebral Hemorrhage in a Tri-ethnic Cohort: The ERICH Study

Stroke ◽

10.1161/str.44.suppl_1.atp188 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Lee Birnbaum ◽

Anne Leonard ◽

Julio Andino ◽

Charles J Moomaw ◽

Carl Langfeld ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Univariate Analysis ◽

Case Fatality ◽

Final Model ◽

Location Data ◽

History Of ◽

Race Ethnicity ◽

Pairwise Testing ◽

Racial Ethnic ◽

Control Study

Background: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) is an ongoing case-control study of spontaneous ICH among non-hispanic whites, non-hispanic blacks, and Hispanics. Prior studies have identified hypertension as a greater risk for non-lobar (NL) ICH as compared with lobar (L) ICH. Given the greater reported prevalence of hypertension among black and Hispanic populations, we hypothesized that the location of ICH may differ by race/ethnicity. Methods: At the time of this analysis, we had ICH location data, lobar vs. non-lobar, on 648 subjects. We performed univariate analysis on known and potential predictors of ICH location: age, sex, race/ethnicity, hypertension, diabetes, BMI, creatinine, cholesterol, aspirin use, smoking, alcohol use, caffeine use, and INR. INR was dichotomized at >1.1. After forcing in age, sex, race, history of diabetes, aspirin use and INR, we added significant and near-significant (p<0.2) variables in a stepwise fashion to complete our final logistic regression model. Our outcome measure was lobar ICH. Conditional pairwise testing was performed for race/ethnicity. Results: Of the 648 subjects (mean age 61.12 ± 14.51 years; 39.8% female; 35.0% Hispanic, 26.5% white, 38.4% black), 181 (27.9%) presented with lobar ICH. Hypertension was present in 525 subjects (75.1% L, 83.3% NL; p=.018), diabetes in 152 (26.0% L, 22.5% NL; p=.348), high cholesterol in 244 (45.9% L, 34.5% NL; p=.008), aspirin use in 200 (37.0% L, 28.5% NL; p=.035), and INR >1.1 (24.1% L, 21.8% NL; p=.535) In our final model, race/ethnicity (p<.024) was associated with location of ICH. Furthermore, white race/ethnicity was associated with L ICH, compared with black (b=.57, p=.016) or Hispanic (b=.56, p=.018). Hypertension (b=-0.63, p=.009) was associated with NL ICH, and smoking (b=0.51, p=.007) was associated with L ICH. Discussion: Our results suggest that there are significant racial/ethnic differences in the distribution of lobar and non-lobar ICH. The conditional pairwise testing for race/ethnicity showed a significantly higher rate of lobar ICH in whites, compared with blacks or Hispanics. These findings are intriguing given the differences in case-fatality rates and age at ICH onset.

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