Navigation Links
Survival After Stroke Better for Blacks

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 large-vessel distribution strokes," Goldstein said.

Holloway agreed. "We can't exclude that possibility," he said. "But there is something going on that is more than just small vessel versus large vessel -- there is something more there. My gut tells me [the care they are getting] has to be part of the explanation."

The report is published in the Feb. 1 issue of the Annals of Internal Medicine.

For the study, Holloway's team collected data on 5,319 black patients and 18,340 white patients hospitalized for stroke from January 2005 to December 2006.

During follow-up, 5 percent of the black patients died in the hospital, compared with 7.4 percent of the white patients. After 30 days, 6.1 percent of the black patients died from any cause, compared with 11.4 percent of the white patients, the researchers found.

After one year, 16.5 percent of the black patients had died, compared with 24.4 percent of the white patients, they reported.

In addition, black patients were 22 percent more likely to receive more aggressive care than whites.

Moreover, compared with white patients, black patients were 75 percent less likely to be admitted to a hospice after leaving the hospital, Holloway's group found.

Holloway thinks these findings are important, especially in light of the new paradigm called patient-centered care. How care options are explained and decisions about care are made have become areas that need to be better understood, he said. This includes how patients and their families make these decisions, he added.

"There is a lot of policy now that uses 30-day mortality as a measure of quality," he said. The question is "are there incidences when you have a well-informed patient who decides to forgo life-sustaining interventions -- that has a higher mortality, but it could be excellent quality," Holloway said. "Using 30-day mortality as a measure of quality may not be as simple as it sounds."

More information

For more information on stroke, visit the U.S. National Library of Medicine.

SOURCES: Robert Holloway, M.D., M.P.H., professor, neurology, University of Rochester, Rochester, N.Y.; Larry B. Goldstein, M.D., professor, neurology, and director, Duke Stroke Center, Duke University Medical Center, Durham, N.C.; Feb. 1, 2011, Annals of Internal Medicine

Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Ultrasound and a blood test can increase survival after myocardial infarction
2. Small Spreads of Breast Cancer May Not Affect Survival
3. Funding to improve cancer survival rates
4. Not All Heart Failure Drugs Boost Survival Equally
5. Cancer cell survival is not miR-ly dependent on p53
6. Loss of gene promotes brain-tumor development, reduces survival, study finds
7. Intensive chemotherapy can dramatically boost survival of older teenage leukemia patients
8. Liver Cancer Survival Rates May Be Worse for Blacks
9. Rash Due to Lung Cancer Drug May Be Linked to Better Survival
10. New combo lung cancer therapy improves survival over single-line treatment
11. Gene Research Sheds Light on Lung Cancer Survival Time
Post Your Comments:
Related Image:
Survival After Stroke Better for Blacks  
(Date:11/24/2015)... ... November 24, 2015 , ... The ... comes to several aspects of orthopedic care. They have received recognition for excellence ... general orthopedic care. , Becker's Hospital Review selected hospitals for inclusion based ...
(Date:11/24/2015)... Salt Lake City, UT (PRWEB) , ... November 24, 2015 , ... ... according to Forbes Magazine. For a business, it is critical that the first impression ... of a business, they are not likely to buy anything or want to return. ...
(Date:11/24/2015)... ... November 24, 2015 , ... Brillouin Energy ... Brillouin is the developer of renewable energy technologies capable of producing commercially useful ... announced today that its WET™ and HHT™ Boiler System reactor core modules were ...
(Date:11/24/2015)... ... November 24, 2015 , ... United Benefit ... welcome Winter-Dent & Company as its newest Partner Firm. Based in Jefferson City, ... client's most trusted advisor regardless of whether that client is a business, a ...
(Date:11/24/2015)... ALEXANDRIA, VA (PRWEB) , ... November 24, 2015 ... ... encourages people across the United States to support their local poison centers through ... been designated as #GivingTuesday: calls it “a day that inspires people to ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... --  HeartWare International, Inc . (NASDAQ: HTWR ), ... that are revolutionizing the treatment of advanced heart failure, ... Doug Godshall is scheduled to present at the ... December 1, 2015 at 3:00 p.m. ET.  The conference ... York . .  A ...
(Date:11/24/2015)... F1000Workspace - a research collaboration, reference management ... just six months ago. --> F1000Workspace - ... - since it was launched just six months ago. ... F1000Workspace - a research collaboration, reference management and ... six months ago. --> --> ...
(Date:11/24/2015)... , Nov. 24, 2015 iRhythm Technologies, Inc. ... cardiac care, today announced that it will participate in the 27th ... in New York, NY . Kevin ... on Tuesday December 1, 2015 at 8:50am ET. ... . --> . --> ...
Breaking Medicine Technology: