Key result
Younger stroke survivors, especially Black (AOR=2.17) and Hispanic (AOR=3.29) patients, had higher odds of Central Post-Stroke Pain, indicating potential disparities.
Why the study?
Despite its clinical importance, gaps persist in the recognition and diagnosis of central post-stroke pain, leading to missed treatment and disparities.
Central Post-Stroke Pain is likely underdiagnosed and disproportionately affects younger, Black, and Hispanic stroke survivors.
May signal CPSP underrecognition in younger Black and Hispanic survivors; leaves open equitable screening trials.
Background: Central Post-Stroke Pain (CPSP), defined as a neuropathic pain condition following ischemic or hemorrhagic stroke, affects up to one-third of stroke survivors. Despite its clinical importance, gaps persist in recognition and diagnosis, with implications for missed treatment and disparities. Research Question: What demographic characteristics and comorbid conditions are associated with CPSP among stroke survivors. We hypothesized that both demographic profiles and comorbid conditions will be associated with CPSP, and its prevalence will vary among race/ethnicity. Methods: A retrospective, cross-sectional study was conducted using i2b2 de-identified electronic health records repository from an academic medical center in North Central Florida (2014-2024). Adults aged ≥20 years with ischemic or hemorrhagic stroke were identified by ICD-9/10 codes (432.9, 434.91, I60.9, I61- I63). CPSP cases were identified using ICD-9/10 codes (338.0, G89.0). Descriptive statistics, t -tests, chi-square tests, and binomial logistic regression were conducted using Stata 18.0, with statistical significance set at p <.05. Results: Of 32,155 stroke patients, 99 (0.3%) had documented CPSP. CPSP patients were significantly younger (M=59.4, SD= 13.1), than non-CPSP patients (M= 64, SD= 16.9, p =.003). Gender distribution did not significantly differ (CPSP: 54% female, non CPSP: 48% female, p =.29). Black patients had higher odds of CPSP than White patients (AOR= 2.17, 95% CI: 1.38–3.42, p =.001) and Hispanic patients had over threefold higher odds than non-Hispanics (AOR= 3.29, 95% CI: 1.45–7.47, p =.004). Hypertension (75%), hyperlipidemia (49%), and diabetes (39%) were the most common comorbidities among CPSP patients. However, none differed significantly compared to non-CPSP stroke survivors ( p >.05). Atrial fibrillation was significantly less common in CPSP patients ( p =.007). Conclusions: The prevalence of CPSP was lower than published estimates (8%-35%), suggesting underdiagnosis or under-documentation. CPSP was more common among younger, Black, and Hispanic patients, indicating possible disparities in pain recognition or care. Findings support the need for improved screening, diagnosis, and documentation particularly among stroke patients with high vascular comorbidity risk.
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Al‐Zahid et al. (2026) studied this question. Younger stroke survivors, especially Black (AOR=2.17) and Hispanic (AOR=3.29) patients, had higher odds of Central Post-Stroke Pain, indicating potential disparities.
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