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Research Letter
September 2016

Racial Differences in Utilization of Life-Sustaining vs Curative Inpatient Procedures After Stroke

Author Affiliations
  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Neurol. 2016;73(9):1151-1153. doi:10.1001/jamaneurol.2016.1914

Inpatient procedures are integral to routine stroke care. Common nondiagnostic procedures after stroke include intravenous thrombolysis (IVT), mechanical ventilation, hemicraniectomy, carotid revascularization (endarterectomy or stenting), gastrostomy, and tracheostomy. While some of these procedures are considered curative, aiming at improving functional status (IVT) or preventing further stroke (carotid revascularization), others are considered life-sustaining by preventing death in the short term (mechanical ventilation and hemicraniectomy) or long term (gastrostomy and tracheostomy). Race disparities among some stroke-related procedures have been described,1 but a comprehensive comparison of procedure utilization by patients from different racial groups after stroke is lacking. In the present study, we compared racial differences in the use of 6 common nondiagnostic inpatient procedures after stroke; we hypothesized that curative procedures are underutilized while life-sustaining procedures are overutilized in minorities.

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