Medical Student University of Texas Medical Branch in Galveston Galveston, Texas, United States
Introduction: The middle cerebral artery (MCA) is the most common artery affected by stroke, which constitutes a top 5 cause of death in the US totaling over $100 billion in annual costs. Past studies have shown a higher mortality in Black compared to White patients. This study aims to evaluate MCA stroke rates and outcomes based on group differences.
Methods: 1460 patients in the latest (2019) National Inpatient Database with MCA stroke were evaluated for different outcomes based on risk factors. The modifiable risk factors were hospital region, insurance type, county population size, average income based on zip code, and location/teaching status of a hospital. The non-modifiable risk factors were race/ethnicity and birth sex. Dependent variables were tested for significance in RStudio using Yates's chi-squared test and multi-factor analysis of variance.
Results: Mortality in Black patients (7.12%) compared to White (11.80%) was significant (p < 0.05). A significant difference was found between races in number of procedures (p < 0.001), number of diagnoses (p < 0.05), length of stay (p < 0,001), and total charges (p < 0.001). A significant difference (p < 0.05) in mortality was found for counties in metro areas with populations of 250,000-999,999 (13.55%) compared to central metropolitan counties with >1 million people (9.41%) . A significant difference (p < 0.05) in mortality was found between males (12.55%) and females (8.82%). Significant differences were also found between number of procedures (p < 0.01), length of stay (p < 0.05), and total charges (p < 0.05) between males and females. Significance was found for rates of elective admission for private insurance compared to Medicare patients (p < 0.01).
Conclusion : The significant difference found between White patients and Black patients runs counter to past trends. The differences found between stroke patients of different income levels, county size, sex assigned at birth, and insurance type deserve further exploration.
