ArticleStroke2022
Racial Inequities Across Rural Strata in Acute Stroke Care and In-Hospital Mortality: National Trends Over 6 Years.
Article in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Social determinants of health and stroke care and outcomes: SEQUINS lecture 2025.Equity neuroscience · 2026Article
- Hospital Socioeconomic Status and Acute Stroke Treatment in the United States.Cerebrovascular diseases (Basel, Switzerland) · 2026Article
- Racial and ethnic disparities in access to acute stroke capabilities in California: Association with rurality and telestroke access.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026Article
- Changes in Healthcare Utilization Patterns and Outcomes for an Acute Cerebrovascular Events Medicare Cohort: 2018-2022.Neuroepidemiology · 2026Article
- Review
- Variations in Methodological Approaches to Measuring Health Inequalities and Inequities: A Scoping Review of Acute Stroke Pathways.Healthcare (Basel, Switzerland) · 2025Review
- Intersection of Race and Rurality With Health Care-Associated Infections and Subsequent Outcomes.JAMA network open · 2025Article
- Review
- Regional Disparities in Hyperacute Treatment and Functional Outcomes after Acute Ischemic Stroke in Japan.Journal of atherosclerosis and thrombosis · 2024Article
- THE ROLE OF HEALTH POLICY IN IMPROVING HEALTH OUTCOMES AND HEALTH EQUITY.Transactions of the American Clinical and Climatological Association · 2024Article
- Black Americans have worse stroke outcome compared with non-Hispanic whites.Journal of the National Medical Association · 2023Article
- Racial and Ethnic Disparities in Stroke Reperfusion Therapy in the USA.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023Review
- Spatial-temporal analysis of cerebral infarction mortality in Hokkaido, Japan: an ecological study using a conditional autoregressive model.International journal of health geographics · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
Abstract
backgroundThere are glaring racial and rural-urban inequities in stroke outcomes. The objective of this study was to determine whether there were recent changes to trends in racial inequities in stroke treatment and in-hospital mortality, and whether racial inequities differed across rural strata.
methodsRetrospective analysis of Black and White patients >18 years old admitted to US acute care hospitals with a primary discharge diagnosis of stroke (unweighted N=652 836) from the National Inpatient Sample from 2012 to 2017. Rural residence was classified by county as urban, town, or rural. The primary outcomes were intravenous thrombolysis and endovascular therapy use among patients with acute ischemic stroke, and in-hospital mortality for all stroke patients. Logistic regression models were run for each outcome adjusting for age, comorbidities, primary payer, and ZIP code median income.
resultsThe sample was 53% female, 81% White, and 19% Black. Black patients from rural areas had the lowest odds of receiving intravenous thrombolysis (adjusted odds ratio [aOR], 0.43 [95% CI, 0.37-0.50]) and endovascular therapy (aOR, 0.60 [0.46-0.78]), compared with White urban patients. Black rural patients were the least likely to be discharged home after a stroke compared with White/urban patients (aOR, 0.79 [0.75-0.83]), this was true for Black patients across the urban-rural spectrum when compared with Whites. Black patients from urban areas had lower mortality than White patients from urban areas (aOR, 0.87 [0.84-0.91]), while White patients from rural areas (aOR, 1.14 [1.10-1.19]) had the highest mortality of all groups.
conclusionsBlack patients living in rural areas represent a particularly high-risk group for poor access to advanced stroke care and impaired poststroke functional status. Rural White patients have the highest in-hospital mortality. Clinical and policy interventions are needed to improve access and reduce inequities in stroke care and outcomes.
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