Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial

VISTA-ICH collaboration and ENOS Investigators

doi:10.1177/1747493017744463

Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial

VISTA-ICH collaboration and ENOS Investigators

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

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.

Original language	English
Journal	International journal of stroke : official journal of the International Stroke Society
Volume	13
Issue number	4
Pages (from-to)	362-373
Number of pages	12
ISSN	1747-4930
DOIs	https://doi.org/10.1177/1747493017744463
Publication status	Published - 1 Jun 2018

Keywords

African Continental Ancestry Group/ethnology
Aged
Analysis of Variance
Asian Continental Ancestry Group/ethnology
Cerebral Hemorrhage/diagnostic imaging
European Continental Ancestry Group/ethnology
Female
Humans
Male
Neuroimaging/methods
Nitric Oxide/therapeutic use
Quality of Life
Randomized Controlled Trials as Topic
Stroke/diagnostic imaging
Tomography, X-Ray Computed
Treatment Outcome

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VISTA-ICH collaboration and ENOS Investigators (2018). Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial. International journal of stroke : official journal of the International Stroke Society, 13(4), 362-373. https://doi.org/10.1177/1747493017744463

Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial. / VISTA-ICH collaboration and ENOS Investigators.
In: International journal of stroke : official journal of the International Stroke Society, Vol. 13, No. 4, 01.06.2018, p. 362-373.

Research output: Contribution to journal › Journal article › Research › peer-review

VISTA-ICH collaboration and ENOS Investigators 2018, 'Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial', International journal of stroke : official journal of the International Stroke Society, vol. 13, no. 4, pp. 362-373. https://doi.org/10.1177/1747493017744463

VISTA-ICH collaboration and ENOS Investigators. Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial. International journal of stroke : official journal of the International Stroke Society. 2018 Jun 1;13(4):362-373. doi: 10.1177/1747493017744463

VISTA-ICH collaboration and ENOS Investigators. / Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage : Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial. In: International journal of stroke : official journal of the International Stroke Society. 2018 ; Vol. 13, No. 4. pp. 362-373.

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title = "Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial",

abstract = "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.",

keywords = "African Continental Ancestry Group/ethnology, Aged, Analysis of Variance, Asian Continental Ancestry Group/ethnology, Cerebral Hemorrhage/diagnostic imaging, European Continental Ancestry Group/ethnology, Female, Humans, Male, Neuroimaging/methods, Nitric Oxide/therapeutic use, Quality of Life, Randomized Controlled Trials as Topic, Stroke/diagnostic imaging, Tomography, X-Ray Computed, Treatment Outcome",

author = "Kailash Krishnan and Lucy Beishon and Eivind Berge and Hanne Christensen and Dineen, {Robert A} and Serefnur Ozturk and Nikola Sprigg and Wardlaw, {Joanna M} and Bath, {Philip M} and {VISTA-ICH collaboration and ENOS Investigators}",

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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 : official journal of the International Stroke Society

JF - International journal of stroke : official journal of the International Stroke Society

IS - 4

ER -