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Survival After Stroke Better for Blacks
Date:1/31/2011

By Steven Reinberg
HealthDay Reporter

MONDAY, Jan. 31 (HealthDay News) -- Although blacks face a higher risk of having a stroke, they appear to have better odds of surviving one than whites do, a new study finds.

This finding might seem odd since conventional wisdom says black patients typically fare worse than whites when it comes to medical care in general. However, the same trend has been noticed in other areas such as heart attack and heart failure, hip fractures and gastrointestinal bleeding, the University of Rochester researchers added.

"The question is why that might be the case," said study author Dr. Robert Holloway, a professor of neurology.

To answer that question, the researchers looked into several possibilities, particularly the care patients received. They found that black patients were more likely than whites to have aggressive care, which Holloway believes played a major role in their improved survival.

The more aggressive measures included dialysis, a tracheostomy (a breathing tube) or cardiac resuscitation, Holloway said. Blacks had a higher rate of these interventions than whites, he noted.

"Maybe part of the difference in survival [between blacks and whites] may be the different rate of life-sustaining intervention," Holloway said.

Why black patients have higher rates of these treatments isn't known, he added. But part of it may be the care decisions black patients and their families make compared to the ones white patients and their families make, Holloway said.

However, Dr. Larry B. Goldstein, a professor of neurology and director of the Duke Stroke Center at Duke University Medical Center thinks the reason may be biological.

"Stroke severity is the single most important determinant of outcome," he said. "African Americans more commonly have small vessel-type strokes than non-African Americans, which are generally less severe and have a better prognosis than
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