#USA #Seattle #Society of NeuroInterventional Surgery #Stroke Disparities #Healthcare Inequality

Ongoing Racial Disparities in Stroke Treatment in the U.S.

Recent research presented at the Society of NeuroInterventional Surgery's (SNIS) 23rd Annual Meeting in Seattle has unveiled significant racial and geographic disparities in stroke treatment and outcomes. Three separate studies conducted between 2018 and 2024 reflect a troubling trend: while advances in stroke care have improved the overall survival rates and treatment options available, not every patient is benefiting equally.

Analysis of Stroke Patients

The first study titled "Racial Disparities in Endovascular Thrombectomy Widen with Stroke Severity" analyzed the data of over 325,000 acute ischemic stroke patients treated at U.S. teaching hospitals from 2018 to 2022. The findings indicated that Black patients were significantly less likely to receive endovascular thrombectomy (EVT)—a minimally invasive procedure used to remove clots that block blood flow to the brain—compared to their white counterparts.

Interestingly, the gap in treatment was found to widen as stroke severity increased. Data showed that at a National Institutes of Health Stroke Scale (NIHSS) score of 20, the likelihood of receiving EVT was estimated at 33% for white men, 32% for white women, while only 28% for Black men, and dropping to 26% for Black women. Dr. Muhammed Amir Essibayi, one of the study's co-authors, emphasized the importance of identifying the intersection of race, sex, and stroke severity—pointing out a critical opportunity for health systems to ensure equitable access to necessary treatments.

Mortality Rates in Hemorrhagic Stroke

The second study, named "Reducing Inequalities in Stroke Events-Hemorrhagic Disparities", focused on data from over 120,000 patients hospitalized with hemorrhagic stroke in Florida over a decade. Though mortality rates in general showed a significant decline, stark disparities remained among different racial, geographic, and socio-economic groups. Notably, Black patients were found to have higher odds of in-hospital mortality compared to white patients, especially among those living in rural areas or relying on Medicaid and other non-commercial insurance.

Dr. Natália Vasconcellos, a neurology resident at Thomas Jefferson University Hospital, explained that while the reduction in mortality rates was encouraging, it highlighted the critical barriers that still need to be addressed, especially for underserved communities.

Urban vs. Rural Disparities

The third study titled "Dual Pathways to Hemorrhagic Stroke Mortality Across the U.S. Stroke Belt" explored mortality outcomes across 433 counties categorized as being part of the