TY - JOUR
T1 - Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage
T2 - Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial
AU - Krishnan, Kailash
AU - Beishon, Lucy
AU - Berge, Eivind
AU - Christensen, Hanne
AU - Dineen, Robert A
AU - Ozturk, Serefnur
AU - Sprigg, Nikola
AU - Wardlaw, Joanna M
AU - Bath, Philip M
AU - VISTA-ICH collaboration and ENOS Investigators
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background and purpose Although poor prognosis after intracerebral hemorrhage relates to risk factors and hematoma characteristics, there is limited evidence for the effect of race-ethnicity. Methods Data from 1011 patients with intracerebral hemorrhage enrolled into hyperacute trials and randomized to control were obtained from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke Trial. Clinical characteristics and functional outcome were compared among three racial groups - Asians, Blacks, and Caucasians. Results The majority of patients were Caucasian (78.1%) followed by Asians (14.5%) and Blacks (5.5%). At baseline, Caucasians were older and had larger hematoma volumes; Blacks had lower Glasgow Coma Scale and higher systolic blood pressure (all p < 0.05). Although the primary outcome of modified Rankin Scale did not differ at 90 days (p = 0.14), there were significant differences in mortality (p < 0.0001) and quality of life (EQ-5D p < 0.0001; EQ-VAS p 0.015). In test of multiple comparisons, Caucasians were more likely to die (p = 0.0003) and had worse quality of life (EQ-5D p = 0.003; EQ-VAS p < 0.0001) as compared to Asians. Conclusion Race-ethnicity appears to explain some of the variation in clinical characteristics and outcomes after acute intracerebral hemorrhage. Factors that explain this variation need to be identified.
AB - Background and purpose Although poor prognosis after intracerebral hemorrhage relates to risk factors and hematoma characteristics, there is limited evidence for the effect of race-ethnicity. Methods Data from 1011 patients with intracerebral hemorrhage enrolled into hyperacute trials and randomized to control were obtained from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke Trial. Clinical characteristics and functional outcome were compared among three racial groups - Asians, Blacks, and Caucasians. Results The majority of patients were Caucasian (78.1%) followed by Asians (14.5%) and Blacks (5.5%). At baseline, Caucasians were older and had larger hematoma volumes; Blacks had lower Glasgow Coma Scale and higher systolic blood pressure (all p < 0.05). Although the primary outcome of modified Rankin Scale did not differ at 90 days (p = 0.14), there were significant differences in mortality (p < 0.0001) and quality of life (EQ-5D p < 0.0001; EQ-VAS p 0.015). In test of multiple comparisons, Caucasians were more likely to die (p = 0.0003) and had worse quality of life (EQ-5D p = 0.003; EQ-VAS p < 0.0001) as compared to Asians. Conclusion Race-ethnicity appears to explain some of the variation in clinical characteristics and outcomes after acute intracerebral hemorrhage. Factors that explain this variation need to be identified.
KW - African Continental Ancestry Group/ethnology
KW - Aged
KW - Analysis of Variance
KW - Asian Continental Ancestry Group/ethnology
KW - Cerebral Hemorrhage/diagnostic imaging
KW - European Continental Ancestry Group/ethnology
KW - Female
KW - Humans
KW - Male
KW - Neuroimaging/methods
KW - Nitric Oxide/therapeutic use
KW - Quality of Life
KW - Randomized Controlled Trials as Topic
KW - Stroke/diagnostic imaging
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
U2 - 10.1177/1747493017744463
DO - 10.1177/1747493017744463
M3 - Journal article
C2 - 29165060
SN - 1747-4930
VL - 13
SP - 362
EP - 373
JO - International Journal of Stroke
JF - International Journal of Stroke
IS - 4
ER -