Key result
Arab patients with acute ischemic stroke had different risk factors and prehospital delays than Jewish patients, but showed no differences in stroke severity, management, disability, or mortality.
Observational (n=1,540)
Yes
Despite differences in baseline risk factors and hospital arrival patterns, Arab and Jewish patients with acute ischemic stroke in Israel experience similar clinical outcomes and long-term mortality.
Similar outcomes despite ethnic differences in risks and delays support equitable acute care; leaves open targeted prevention and delay-reduction strategies.
BACKGROUND: We intended to determine ethnic differences in the characteristics, management and outcome of acute ischemic stroke between the Israeli Arab and Jewish populations. METHODS: A national survey was conducted in 2004 at all 28 hospitals in Israel. Information on demographics, transportation, risk factors, clinical presentation, stroke severity, type and subtype, management and clinical outcome was obtained. Mortality during the 36 months after hospitalization was assessed by matching with national mortality data. RESULTS: Of the 1,540 patients, 169 (11%) were Arabs and 1,371 (89%) were Jews. The mean age of Arab patients was 9 years younger than in Jewish patients (63 ± 11 vs. 72 ± 12 years). Also, Arabs were more likely to be obese (OR = 1.72; 95% CI: 1.19-2.50) and have diabetes (OR = 1.41; 95% CI: 1.01-1.96), while Jews were more likely to have dyslipidemia (OR = 1.56; 95% CI: 1.11-2.17). A greater percentage of the Arab patients arrived at the hospital independently (OR = 3.85; 95% CI: 2.56-5.56) and were less likely to arrive within 3 h of symptom onset (OR = 2.33; 95% CI: 1.39-3.85). Arabs suffered increased rates of lacunar stroke (OR = 1.67; 95% CI: 1.14-2.43) and were discharged home more often (OR = 2.40; 95% CI: 1.35-4.25). No differences in severity of stroke, management, complications, disability or mortality were found between the 2 groups. CONCLUSIONS: The unique characteristics of the Arab and Jewish populations should be considered when planning stroke-care services and culturally oriented public education programs.
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Gross et al. (2011) conducted an observational in Acute ischemic stroke (n=1,540). Arab ethnicity vs. Jewish ethnicity was evaluated on Severity of stroke, management, complications, disability or mortality. Arab patients with acute ischemic stroke had different risk factors and prehospital delays than Jewish patients, but showed no differences in stroke severity, management, disability, or mortality.
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