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Loss of the Mexican American survival advantage after ischemic stroke
Journal article   Open access   Peer reviewed

Loss of the Mexican American survival advantage after ischemic stroke

Lewis B Morgenstern, Devin L Brown, Melinda A Smith, Brisa N Sánchez, Darin B Zahuranec, Nelda Garcia, Kevin A Kerber, Lesli E Skolarus, William J Meurer, James F Burke, …
Stroke (1970), v 45(9), pp 2588-2591
Sep 2014
PMID: 25074514
url
https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.114.005429View
Published, Version of Record (VoR) Open
url
https://doi.org/10.1161/STROKEAHA.114.005429View
Published, Version of Record (VoR) Open

Abstract

Aged Aged, 80 and over Brain Ischemia - ethnology Brain Ischemia - mortality European Continental Ancestry Group Female Humans Incidence Male Mexican Americans Middle Aged Population Surveillance Stroke - ethnology Stroke - mortality Texas - epidemiology Treatment Outcome
Mexican Americans (MAs) were previously found to have lower mortality after ischemic stroke than non-Hispanic whites. We studied mortality trends in a population-based design. Active and passive surveillance were used to find all ischemic stroke cases from January 2000 to December 2011 in Nueces County, TX. Deaths were ascertained from the Texas Department of Health through December 31, 2012. Cumulative 30-day and 1-year mortality adjusted for covariates was estimated using log-binomial models with a linear term for year of stroke onset used to model time trends. Models used data from the entire study period to estimate adjusted mortality among stroke cases in 2000 and 2011 and to calculate projected ethnic differences. There were 1974 ischemic strokes among non-Hispanic whites and 2439 among MAs. Between 2000 and 2011, model estimated mortality declined among non-Hispanic whites at 30 days (7.6% to 5.6%; P=0.24) and 1 year (20.8% to 15.5%; P=0.02). Among MAs, 30-day model estimated mortality remained stagnant at 5.1% to 5.2% (P=0.92), and a slight decline from 17.4% to 15.3% was observed for 1-year mortality (P=0.26). Although ethnic differences in 30-day (P=0.01) and 1-year (P=0.06) mortality were apparent in 2000, they were not so in 2011 (30-day mortality, P=0.63; 1-year mortality, P=0.92). Overall, mortality after ischemic stroke has declined in the past decade, although significant declines were only observed for non-Hispanic whites and not MAs at 1 year. The survival advantage previously documented among MAs vanished by 2011. Renewed stroke prevention and treatment efforts for MAs are needed.

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Web of Science research areas
Clinical Neurology
Peripheral Vascular Disease
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