Abstract WP286: Race and Gender Differences Among Patients With First or Recurrent Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Mary G George ◽  
Xin Tong
Keyword(s):  
Gender Differences ◽  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Hospital Death ◽  
Stroke Severity ◽  
Race And Gender ◽  
Black Females ◽  
White Males ◽  
Black Patients ◽  
And Gender

Introduction: Little information is known about the race and gender differences in stroke severity of acute ischemic stroke (AIS) among those presenting with and without a recurrent stroke (RS). Methods: The study is limited to white and black patients who were admitted with an AIS in the Paul Coverdell National Acute Stroke Program from 2012-2014. There were 157 967 admissions from 453 hospitals identified. After excluding those with missing NIHSS (33 017), the analysis focused on 124 950 patients. Results: The median age of blacks and females was greater than for whites and males, 74 vs 63 and 75 vs 68, respectively. RS accounted for 21.8% of AIS in white males, 21.2% in white females, 28.3% in black males, and 30.0% in black females. The median NIHSS was higher among females with initial stroke or RS stroke (4.0 vs 3.0 and 5.0 vs 4.0, respectively, p<0.0001) and higher among blacks with initial stroke or RS (4.0 vs 3.0 and 5.0 vs 4.0, respectively, p<0.0001). Overall in-hospital death was greater among whites and females compared to blacks and males (4.1% vs 2.9%, p<0.0001; 4.2% vs 3.5%, p<0.0001, respectively), and this pattern was consistent for initial AIS and RS. Use of tPA was greater among whites and males compared to blacks and females (11.6% vs 10.3%, p<0.0001; 11.5 vs 11.1%, p=0.02, respectively). This pattern was consistent for initial AIS and RS by race and for initial AIS by gender, but not for tPA for RS by gender. Females and blacks were less likely to have a mild stroke (NIHSS score 0-4) than males and whites for both initial and RS (p<0.0001). After adjusting for age, state, hospital, and year, the odds of having an NIHSS ≥5 was 16% lower among males, 36% greater among blacks, and 38% greater for those with a RS (data not shown). Conclusion: Race and gender differences on age, stroke severity, receipt of tPA, and in-hospital death among initial AIS patients persist for RS. Blacks, females, and those with a RS have more severe AIS.

Non-Inferior Survival of Black Versus White Patients and Superior Outcomes for Black Females Compared to Other Race/Gender Groups Following Allogeneic Transplantation for Hematologic Malignancy: A Single Center Multivariable Analysis of 475 Allografted Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 401-401
Author(s):  
Asad Bashey ◽  
Xu Zhang ◽  
Katelin Jackson ◽  
Stacey Brown ◽  
Melhem Solh ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Hematologic Malignancy ◽  
Multivariable Analysis ◽  
Race And Gender ◽  
Black Females ◽  
Black And White ◽  
Black Patients ◽  
And Gender ◽  
White Patients

Abstract The effect of race on outcomes following allogeneic hematopoietic cell transplantation (allo-HCT) is unclear. Earlier studies suggested no clear difference between black and white patients for conventional allografts (Baker et al JCO 2005, 23:7032) and inferior outcomes for black patients following single unit umbilical cord blood transplants(UCBT) (Ballen et al BBMT 2012, 18:903). The advent of HLA-haploidentical donor transplantation using T-replete grafts and post-transplant cyclophosphamide (HIDT-ptCy) has improved donor availability for black patients. However, the effect of race on allograft outcomes in the era of HIDT-ptCy has not been reported. We compared outcomes by race in 475 consecutive patients (white=383, black=83, Asian =9) undergoing a first allograft for hematologic malignancy at our center between February 2005 and February 2014. Hispanic/latino was classified as an ethnicity separate from race and was not exclusive of race categories. Patients with < 8 of 8 HLA- A, B, C, DRB1 allele matched unrelated donors, and UCBT were excluded from the analysis. Supportive care algorithms and follow-up assessments were identical for all patients. Median follow-up for living patients was 45 months (range 12-120 months). Patient characteristics and outcome data were obtained from our institutional database where they had been prospectively documented. The Kaplan-Meier method was used to estimate overall survival (OS) and disease-free survival (DFS). Relapse and non-relapse mortality (NRM) were treated as competing risks. There were no significant differences in patient disease and transplant characteristics including Disease Risk Index (DRI) and HCT-CMI between the black and white patients except black patients were younger (median age 46 vs 53), more likely to receive HIDT-ptCy (61% vs. 17%) and less likely to be CMV seronegative pairs (12% vs 27%) (p<0.001 for all). Estimated outcomes at 2 yrs for black versus white patients were as follows: OS-71% vs. 62%( p=0.1, pointwise, p=0.04 Log-rank, Fig 1a); DFS 64% vs 50% (p=0.025 pointwise, p=0.06 Log-rank). Cumulative Incidences at 2 yrs were: NRM 13% vs 16%(p=0.5 pointwise, p=0.44 Gray's test) relapse 23% vs. 34% (p=0.02 pointwise, p=0.18 Gray's test). We found a strong interaction between race and gender for the outcomes assessed. Subsequent analysis were performed for four groups: Black female (BF, n=43), black male (BM, n=40), white female (WF, n=162), white male( WM, n=221). Black females had superior OS (2 yr OS 81%, 63%, 60%, 60% for BF, WF, WM, BM respectively, Log Rank p=0.02, Fig 1b) and DFS (2yr DFS 72%, 52%, 49%, 55% respectively, Log-rank p=0.04). NRM was not different between the four groups (2 yr NRM 12%, 16%, 15%, 15% respectively p=NS) but 2 yr relapse rates were significantly lower in BF (16%) than WF (32%) and WM (35%) (p=0.05 BF vs WF and p=0.01 BF vs WM). Multivariable Cox regression models were built to adjust for significant confounding variables with the race and gender combinations being the main compared group. When compared to WF as a baseline, BF had a significantly improved OS (HR 0.33, p=0.003), DFS (HR 0.49, p=0.025) and relapse rate (HR=0.45, p=0.046) but NRM was not statistically different. WM and BM were not significantly different from WF for any endpoint. These data demonstrate that in the current era when almost all black patients can find a fully matched conventional donor or a haploidentical donor, outcomes following allotransplants for hematologic malignancy for black patients are not inferior to those for white patients and may be superior for BF compared to other race/gender combinations. A lower relapse rate in BF appears to contribute to this difference. Figure 1A. Figure 1A. Figure 1B. Figure 1B. Disclosures No relevant conflicts of interest to declare.

Abstract P532: Hypertension and Gender Differences in Acute Ischemic Stroke Patients Treated With Rtpa

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Thomas I Nathaniel ◽  
Jordan Gainey ◽  
Leah Wormack ◽  
Chibueze Ubah ◽  
Leanne Brechtel ◽  
...  
Keyword(s):  
Gender Differences ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Severe Stroke ◽  
Hypertensive Patients ◽  
Ischemic Cerebrovascular Disease ◽  
And Gender ◽  
Similar Incidence

Background: Women and men have a similar incidence for ischemic cerebrovascular disease but women are more frequently hit by stroke later in life than men. It has been shown that women presented with severe stroke symptoms during admission, a poorer prognosis, are likely to have an overall poorer outcome after ischemic stroke when compared with men. However, some studies indicate similarities in outcome for men and women after stroke. Moreover, there is evidence that women treated with tPA benefit at least as much as men. Since a higher diastolic blood pressure increases the risk for a worse prospective functional status in men, but less significance in women, it is not clear whether hypertensive patients with acute ischemic stroke treated will reveal similarity or difference in functional outcome. We investigated this issue in the current study. Method: We performed a retrospective analysis of 4500 acute ischemic stroke patients who presented to a health care system between January 2010 and June 2016 and received rt-PA. We develop a new tool to determine the possibility of erasing any gender difference, and identify the most important factor for the poorer outcomes in women or men and whether thrombolysis may counteract this effect. Results: Our results reveal that poorer outcomes after stroke and the observed gender differences is due to age, at stroke onset, and that thrombolysis may neutralize this effect. Conclusion: The important factor for the poorer outcome and gender differences in hypertensive patients with acute ischemic stroke is mainly due to stroke severity and thrombolysis may play a major role in neutralizing this effect.

scholarly journals Racial and Gender Differences in Stroke Severity, Outcomes, and Treatment in Patients with Acute Ischemic Stroke

2014 ◽  
Vol 23 (4) ◽  
pp. e255-e261 ◽  
Author(s):  
Amelia K. Boehme ◽  
James E. Siegler ◽  
Michael T. Mullen ◽  
Karen C. Albright ◽  
Michael J. Lyerly ◽  
...  
Keyword(s):  
Gender Differences ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
And Gender

Understanding the Subgroup Complexities of Transfer: The Impact of Juvenile Race and Gender on Waiver Decisions

2019 ◽  
Vol 18 (2) ◽  
pp. 135-155
Author(s):  
Sara L. Bryson ◽  
Jennifer H. Peck
Keyword(s):  
Juvenile Court ◽  
Race And Gender ◽  
Black Females ◽  
White Males ◽  
Joint Influence ◽  
Judicial Waiver ◽  
And Gender ◽  
The Individual ◽  
Court Processing ◽  
The Impact

While prior research has consistently found the presence of extralegal disparities in juvenile justice decision-making, less research has investigated the combined effects of a juvenile’s race and gender on the decision to transfer youth to adult court. The current study examines both the individual and joint influence of race and gender on transfer decisions of all judicial waiver-eligible youth in a Northeast state from 2004 to 2014. Results indicate that Black males had the highest likelihood of being judicially waived, followed by White males, then Black females. White females had the greatest chance of being retained in juvenile court. The findings have important implications for juvenile court processing by informing researchers, practitioners, and policyholders about potential reform efforts that target judicial waiver.

Abstract WP332: Recurrent Ischemic Stroke: Patient Characteristics, Hospital Arrival Mode, And Outcomes, Paul Coverdell National Acute Stroke Program 2016-18

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sallyann Coleman King ◽  
Erika Odom ◽  
Xin Tong
Keyword(s):  
Ischemic Stroke ◽  
Health Care Professionals ◽  
Recurrent Events ◽  
Recurrent Stroke ◽  
Patient Characteristics ◽  
Hospital Death ◽  
Stroke Patients ◽  
Severe Stroke ◽  
Black Patients ◽  
Public Health Practitioners

Introduction: Better characterizing patients with recurrent ischemic stroke, whether they are more likely to arrive by ambulance, and their outcomes is important to reinforcing prevention practices and identifying disparities. Method: We identified 226,974 admissions with a clinical diagnosis of ischemic stroke, age≥18 years, from 463 participating hospitals in the PCNASP from 2016-2018, 58,505 or 25.8% of which had a recurrent stroke. We compared descriptive and clinical features of those with a first stroke with those having recurrent stroke. Results: A higher proportion of recurrent stroke admissions was found among black (vs. white) patients: 32.2% vs 24.3%). Recurrent stroke patients were more likely to arrive by ambulance (52.8% vs 45.0%), suffer a more severe stroke (mean NIHSS 6.8 vs 5.9) and less likely to receive alteplase (7.9% vs 10.9%) than those with their first stroke. In addition, those with a recurrent stroke were also more likely to have worse outcomes with fewer recurrent stroke patients being discharged home (42.7% vs 51%). Small differences were seen in the proportion of recurrent stroke patients who were able to ambulate with assistance before their stroke but were then unable to ambulate at discharge (2.2% vs 0.9% for first stroke patients). There were no significant differences seen for in-hospital death. Conclusion: Black patients with ischemic strokes had a higher proportion of recurrent events. Recurrent stroke patients were more likely to arrive by ambulance, and suffer a more severe stroke and have worse outcomes. Understanding disparities among those with recurrent stroke may support public health practitioners and health care professionals intervene to prevent or manage recurrent stroke.

Race and gender differences in attitudes toward help seeking among marginalized young adults with mood disorders: A mixed-methods investigation.

2018 ◽  
Vol 41 (4) ◽  
pp. 277-289 ◽  
Author(s):  
Sarah C. Narendorf ◽  
Michelle R. Munson ◽  
Shelly Ben-David ◽  
Andrea R. Cole ◽  
Lionel D. Scott
Keyword(s):  
Gender Differences ◽  
Young Adults ◽  
Mixed Methods ◽  
Mood Disorders ◽  
Help Seeking ◽  
Race And Gender ◽  
And Gender

Examination of race and gender differences in predictors of neuropsychological decline and development of Alzheimer’s disease

2021 ◽  
pp. 1-26
Author(s):  
Ellen E. H. Johnson ◽  
Claire Alexander ◽  
Grace J. Lee ◽  
Kaley Angers ◽  
Diarra Ndiaye ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Gender Differences ◽  
Race And Gender ◽  
And Gender

Effects of Receiving Genetic Ancestry Results on Emerging Adults’ Ethnic-Racial Identity Affirmation

2021 ◽  
pp. 216769682110208
Author(s):  
Chelsea D. Williams ◽  
Tricia Smith ◽  
Amy Adkins ◽  
Chloe J. Walker ◽  
Arlenis Santana ◽  
...  
Keyword(s):  
Racial Identity ◽  
Emerging Adults ◽  
Genetic Ancestry ◽  
Male Students ◽  
Race And Gender ◽  
White Males ◽  
Post Test ◽  
And Gender ◽  
Testing Condition ◽  
And Control

Ethnic-racial identity (ERI) is associated with adaptive outcomes in emerging adulthood, but more research is needed on factors that may inform ERI, such as receiving one’s genetic ancestry results. The current study examined changes in ERI using a pre-test post-test design in which 116 emerging adults 18–25 years were randomly assigned to either receiving their genetic ancestry results before the post-test (the testing condition) or after post-test (the control condition). We also tested whether ethnicity/race and gender moderated these associations. Findings indicated that male students of color (SOC) in the testing condition experienced an increase in ERI affirmation from pre-test to post-test, and male SOC in the control condition experienced a decrease in ERI affirmation from pre-test to post-test. There were no significant differences in ERI affirmation change between students in the testing condition and control condition for female SOC, White males, or White females.

scholarly journals Incidence of systemic lupus erythematosus race and gender differences

1995 ◽  
Vol 38 (9) ◽  
pp. 1260-1270 ◽  
Author(s):  
Daniel J. Mccarty ◽  
Susan Manzi ◽  
Thomas A. Medsger ◽  
Rosalind Ramsey-Goldman ◽  
Ronald E. Laporte ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Gender Differences ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Race And Gender ◽  
And Gender
Sign in / Sign up

Export Citation Format

Share Document