Evidence map›Paper›PMID 40832710›Full record

ArticleStroke2025

National Versus State-Level Racial Disparities in Acute Stroke Interventions Using Get With The Guidelines-Stroke Data.

Jennifer A Kim, Alison Herman, Peter Shrader, Brooke Alhanti, Ying Xian, Guido J Falcone, Brian Mac Grory, Eric E Smith, Steven R Messe, Adam de Havenon and 2 more

Abstract read
In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jennifer A KimDepartment of Neurology (J.A.K., A.H., G.J.F., A.d.H., K.N.S.), Yale School of Medicine, New Haven, CT.ORCID 0000-0003-3072-6198
Alison HermanDepartment of Neurology (J.A.K., A.H., G.J.F., A.d.H., K.N.S.), Yale School of Medicine, New Haven, CT.ORCID 0000-0002-5824-3924
Peter ShraderDepartment of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Duke University, Durham, NC (P.S., B.A.).
Brooke AlhantiDepartment of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Duke University, Durham, NC (P.S., B.A.).ORCID 0000-0003-4243-8062
Ying XianDepartment of Neurology, University of Texas Southwestern Medical Center, Dallas (Y.X.).ORCID 0000-0002-1237-1162
Guido J FalconeDepartment of Neurology (J.A.K., A.H., G.J.F., A.d.H., K.N.S.), Yale School of Medicine, New Haven, CT.ORCID 0000-0002-6407-0302
Brian Mac GroryDepartment of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.).ORCID 0000-0003-3914-8419
Eric E SmithDepartment of Clinical Neurosciences, University of Calgary, AB, Canada (E.E.S.).ORCID 0000-0003-3956-1668
Steven R MesseDepartment of Neurology, University of Pennsylvania School of Medicine, Philadelphia (S.R.M.).ORCID 0000-0003-3108-5441
Adam de HavenonDepartment of Neurology (J.A.K., A.H., G.J.F., A.d.H., K.N.S.), Yale School of Medicine, New Haven, CT.ORCID 0000-0001-8178-8597
Gregg C FonarowDivision of Cardiology, University of California, Los Angeles (G.C.F.).ORCID 0000-0002-3192-8093
Kevin N ShethDepartment of Neurology (J.A.K., A.H., G.J.F., A.d.H., K.N.S.), Yale School of Medicine, New Haven, CT.ORCID 0000-0003-2003-5473

Funding

EEG and MRI Biomarkers to Predict Post-traumatic EpilepsyK23NS112596 · NINDS · YALE UNIVERSITY · PI KIM, JENNIFER A · 2020 to 2024
$950k
Electroencephalographic signatures of dysfunctional cerebrovascular autoregulation as biomarkers of brain injury in aneurysmal subarachnoid hemorrhage (SAH)R21NS128641 · NINDS · YALE UNIVERSITY · PI KIM, JENNIFER A, MATOUK, CHARLES · 2023 to 2024
$461k
Role of inhibitory interneurons in generating febrile seizuresF30NS060325 · NINDS · BROWN UNIVERSITY · PI KIM, JENNIFER A · 2008 to 2012
$163k
NINDS NIH HHS F30 NS060325NINDS NIH HHS K23 NS112596NINDS NIH HHS R21 NS128641
6 · The paper itself

Abstract

backgroundRacial disparities have been reported in stroke care, but understanding if there is regional variability is critical to focusing policies and resources. Here, we sought to study racial and ethnic inequity in the administration of thrombolysis and thrombectomy at the national and state levels.

methodsWe conducted a retrospective cohort study using Get With The Guidelines-Stroke Program registry data from 2003 to 2022 to evaluate racial disparities in the administration of acute stroke treatments in US patients. We used mixed-effects modeling to analyze national and state-level disparities, adjusting for relevant demographic, clinical, and hospital-level characteristics.

resultsA total of 660 369 patients were eligible for thrombolysis and 105 184 patients for thrombectomy. The mean age was 70.21±14.48 years, and 50.18% were female. The race/ethnic distribution was 69.06% of non-Hispanic White, 16.88% of non-Hispanic Black, 7.02% of Hispanic, 2.84% of Asian, and 4.20% of American Indian/Alaska Native/Hawaiian/Pacific Islander patients. Eligible non-Hispanic Black patients had statistically higher thrombolytic rates compared with non-Hispanic White patients (adjusted odds ratio [aOR], 1.04 [95% CI, 1.03-1.06]), indicating no racial disparities in thrombolytic treatment at the national level. Similarly, equal or higher rates of thrombolytic administration were noted in other race/ethnic groups at the national level (Asian: aOR, 1.12 [95% CI, 1.09-1.16]; Hispanic: aOR, 1.14 [95% CI, 1.12-1.17]; and other: aOR, 1.10 [95% CI, 1.07-1.13];

conclusionsThese data suggest that racial/ethnic disparities in stroke care vary depending on the intervention and geographic location. Equitable utilization of thrombolysis nationally may underscore the benefits of quality improvement initiatives though state-level inequities persist. Endovascular thrombectomy utilization demonstrated race-based disparities in use, and further efforts are needed to ensure equitable care of patients with stroke in the United States.

Indexed as

Healthcare DisparitiesRacial GroupsStrokeThrombectomyThrombolytic TherapyAgedAged, 80 and overCohort StudiesEthnicityFemaleHumansMaleMiddle AgedPractice Guidelines as TopicRegistriesRetrospective Studiesethnicityracial groupssample sizestroketherapeuticsthrombectomy

Identifiers

PMID40832710
PMCPMC12581475

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.