University of Michigan Medical School, Ann Arbor (C.N.H., L.L., L.B.M.).
University of Michigan School of Public Health, Ann Arbor (R.G., S.K., L.L., L.B.M.).
Stroke. 2020 Oct;51(10):3129-3132. doi: 10.1161/STROKEAHA.120.030915. Epub 2020 Sep 1.
We analyzed differences in 90-day poststroke outcomes between Mexican Americans born in the United States (nonimmigrant) compared with those born outside the United States (immigrant).
We performed a retrospective analysis of prospective data from the population-based Brain Attack Surveillance in Corpus Christi project. We identified stroke cases from 2008 to 2016 and quantified functional, cognitive, and neurological outcomes. Associations between outcome scores and immigration status were analyzed using weighted linear regression models.
Eighty-three Mexican American stroke cases (n=935) were immigrants, and 852 stroke cases were nonimmigrants. Average length of stay in the United States for immigrants was 47 years. Immigrants were older (69 versus 66 years), more likely men (60% versus 49%), had less education on average, and were more likely to have atrial fibrillation compared with nonimmigrants. No differences in other comorbidities existed between groups. After adjustment for confounders, immigrants had better functional outcomes (activities of daily living/instrumental activities of daily living; mean difference, -0.22; =0.02; 1-4, higher scores worse) and no difference in neurological outcomes (log-National Institutes of Health Stroke Scale; mean difference, -0.15; =0.15; 0-44, higher scores worse) or cognitive outcomes (3 Mini-Mental State Examination; mean difference, -0.79; =0.64; 0-100, lower scores worse).
Long-term Mexican American immigrants in this community display better stroke functional outcomes than nonimmigrant Mexican Americans and comparable neurological and cognitive outcomes.
我们分析了在美国出生的墨西哥裔美国人（非移民）与在美国境外出生的墨西哥裔美国人（移民）之间 90 天后脑卒中结局的差异。
我们对基于人群的 Corpus Christi 脑卒中专案的前瞻性数据进行了回顾性分析。我们从 2008 年至 2016 年确定了脑卒中病例，并量化了功能、认知和神经结局。使用加权线性回归模型分析结局评分与移民身份之间的关联。
83 例墨西哥裔美国脑卒中病例（n=935）为移民，852 例脑卒中病例为非移民。移民在美国的平均居住时间为 47 年。与非移民相比，移民年龄更大（69 岁比 66 岁），男性更多（60%比 49%），平均受教育程度更低，且更易发生心房颤动。两组之间在其他合并症方面无差异。在调整混杂因素后，移民的功能结局更好（日常生活活动/工具性日常生活活动；平均差异，-0.22；=0.02；1-4，得分越高表示结局越差），神经结局（国立卫生研究院脑卒中量表评分；平均差异，-0.15；=0.15；0-44，得分越高表示结局越差）或认知结局（3 分钟简易精神状态检查；平均差异，-0.79；=0.64；0-100，得分越低表示结局越差）无差异。
在本社区，长期的墨西哥裔美国移民表现出比非移民墨西哥裔美国人更好的脑卒中功能结局，且具有相似的神经和认知结局。
