以色列犹太人和阿拉伯人群在急性中风治疗方面存在差异吗？来自以色列国家急性中风登记处的结果。

Are there disparities in acute stroke treatment between the Jewish and Arab populations in Israel? Results from the National Acute Stroke Israeli registry.

作者信息

Simaan Naaem, Filioglo Andrei, Honig Asaf, Horev Anat, Orion David, Bornstein Natan M, Telman Gregory, Tanne David, Raphaeli Guy, Amsalem Jacob, Hadar Neuman, Habib-Simaan Reem, Cohen Jose E, Leker Ronen R

机构信息

Department of Neurology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.

Soroka Medical Center, POB151, Beer Sheva 85025, Israel.

出版信息

J Neurol Sci. 2021 Apr 15;423:117357. doi: 10.1016/j.jns.2021.117357. Epub 2021 Feb 20.

DOI:10.1016/j.jns.2021.117357

PMID:33725592

Abstract

BACKGROUND

According to the latest reported data from the National Acute Stroke Israeli Survey (NASIS), around 18,000 strokes occur annually in Israel. Data regarding disparities in stroke care between the Jewish and the Arab populations in Israel are lacking.

AIMS

We wished to compare demographics, comorbidities, stroke characteristics and outcomes between Jewish and Arab stroke patients in Israel that were acutely treated with intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), in order to test if there are disparities or any ethnic-specific parameters.

METHODS

The National Acute Stroke Israeli registry of patients undergoing revascularization (NASIS-REVASC) prospectively enrolled patients in six comprehensive stroke centers between 1/2014 and 3/2016. In this observational research, we compared demographics, comorbidities, time metrics, stroke characteristics and outcomes between Jewish and Arab patients enrolled.

RESULTS

NASIS-REVASC included 1432 patients out of which 143 (10%) were of Arab ethnicity and 1289 (90%) of Jewish ethnicity. Arab patients were significantly younger (66 ± 14 vs. 73 ± 29, p = 0·004), exhibited higher rates of smoking and diabetes (31% vs. 18% and 57% vs. 34%, p < 0·001 for both), and were less often treated with systemic thrombolysis (48% vs. 59%, p = 0·012). However, the rates of any interventional treatment with either intravenous thrombolysis or endovascular thrombectomy as well as the rates of favorable outcomes and mortality were comparable between groups.

CONCLUSIONS

Despite several baseline differences between Arab and Jewish Israeli stroke patients, treatment allocations, survival and functional outcomes were similar indicating lack of disparity in stroke care among patients treated acutely with IVT and/or EVT in Israel.

DATA ACCESS STATEMENT

Full data is available following a formal request to the NASIS-REVASC registry at the Israeli Health Ministry.

摘要

背景

根据以色列国家急性卒中调查（NASIS）最新报告的数据，以色列每年约发生18000例卒中。目前缺乏关于以色列犹太人和阿拉伯人群在卒中治疗方面差异的数据。

目的

我们希望比较在以色列接受静脉溶栓（IVT）和/或血管内血栓切除术（EVT）急性治疗的犹太和阿拉伯卒中患者的人口统计学、合并症、卒中特征及预后，以检验是否存在差异或任何种族特异性参数。

方法

以色列国家急性卒中血管重建患者登记处（NASIS - REVASC）在2014年1月至2016年3月期间前瞻性地纳入了6个综合卒中中心的患者。在这项观察性研究中，我们比较了纳入的犹太和阿拉伯患者的人口统计学、合并症、时间指标、卒中特征及预后。

结果

NASIS - REVASC纳入了1432例患者，其中143例（10%）为阿拉伯族裔，1289例（90%）为犹太族裔。阿拉伯患者明显更年轻（66±14岁 vs. 73±29岁，p = 0.004），吸烟和糖尿病发生率更高（分别为31% vs. 18%和57% vs. 34%，两者p均<0.001），接受全身溶栓治疗的频率更低（48% vs. 59%，p = 0.012）。然而，两组之间静脉溶栓或血管内血栓切除术的任何介入治疗率以及良好预后和死亡率相当。