Ideta Trevor R, Lim Eunjung, Nakagawa Kazuma, Koenig Matthew A
University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii.
University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii; The Queen's Medical Center, Neuroscience Institute, Honolulu, Hawaii.
J Stroke Cerebrovasc Dis. 2018 Jun;27(6):1458-1465. doi: 10.1016/j.jstrokecerebrovasdis.2017.12.042. Epub 2018 Feb 9.
We evaluated disparities in in-hospital mortality rates among whites, Native Hawaiians and other Pacific Islanders (NHOPI), Filipinos, and other Asian groups in Hawaii who were hospitalized for acute ischemic stroke.
Using a statewide hospital claims database, we performed a retrospective study including sequential acute ischemic stroke patients between 2010 and 2015. We compared in-hospital mortality rates among whites, NHOPI, Filipinos, other Asian groups excluding Filipinos, and other races (Blacks, Hispanics, Native Americans, mixed race).
A total of 13,030 patient discharges were included in this study. The mean (±SD) age in years at the time of stroke was 63.5 ± 14.3 for NHOPI, 69.6 ± 14.4 for Filipinos, 67.8 ± 14.2 for other race, 71.4 ± 13.8 for whites, and 76.1 ± 13.5 for other Asians (P < .001). NHOPI patients had higher rates of diabetes (48.8%), obesity (18.4%), and tobacco use (31.3%) compared with patients in other racial-ethnic categories. Filipino patients had the highest rate of hemorrhagic transformation (9.7%). Age-adjusted stroke mortality rates were highest among Filipinos (15.9%; 95% confidence interval [CI] = 14.3%-17.6%), followed by other Asian groups (15.1%; 95% CI = 14.0%-16.2%), NHOPI (14.8%; 95% CI = 12.8%-16.8%), other race (14.4%; 95% CI = 11.3%-17.4%), and lowest among whites (12.8%; 11.5%-14.2%). After adjusting for other confounding variables, Filipinos had higher mortality (odds ratio = 1.22, 95% CI = 1.03-1.45), whereas other Asian groups, NHOPI, and other race patients had mortality rates that were similar to whites.
In Hawaii, Filipino ethnicity is an independent risk factor for higher in-hospital stroke mortality compared with whites.
我们评估了夏威夷因急性缺血性卒中住院的白人、夏威夷原住民及其他太平洋岛民（NHOPI）、菲律宾人以及其他亚洲群体之间的院内死亡率差异。
利用全州医院理赔数据库，我们开展了一项回顾性研究，纳入了2010年至2015年间连续的急性缺血性卒中患者。我们比较了白人、NHOPI、菲律宾人、不包括菲律宾人的其他亚洲群体以及其他种族（黑人、西班牙裔、美洲原住民、混血）之间的院内死亡率。
本研究共纳入13030例患者出院病例。卒中发生时的平均（±标准差）年龄，NHOPI为63.5±14.3岁，菲律宾人为69.6±14.4岁，其他种族为67.8±14.2岁，白人为71.4±13.8岁，其他亚洲人为76.1±13.5岁（P<0.001）。与其他种族-族裔类别的患者相比，NHOPI患者的糖尿病（48.8%）、肥胖（18.4%）和吸烟率（31.3%）更高。菲律宾患者的出血性转化发生率最高（9.7%）。年龄调整后的卒中死亡率在菲律宾人当中最高（15.9%；95%置信区间[CI]=14.3%-17.6%），其次是其他亚洲群体（15.1%；95%CI=14.0%-16.2%）、NHOPI（14.8%；95%CI=12.8%-16.8%）、其他种族（14.4%；95%CI=11.3%-17.4%），在白人当中最低（12.8%；11.5%-14.2%）。在对其他混杂变量进行调整后，菲律宾人的死亡率更高（优势比=1.22，95%CI=1.03-1.45），而其他亚洲群体、NHOPI和其他种族患者的死亡率与白人相似。
在夏威夷，与白人相比，菲律宾族裔是院内卒中死亡率较高的独立危险因素。
