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Background/Objectives: We aimed to determine sex and racial/ethnic disparities in associations between Acute Ischaemic stroke (AIS) with co-morbid heart failure (HF) and in-hospital outcomes, using the US National Inpatient Sample (NIS) in this retrospective observational study based on administrative data. Methods: AIS admissions from January 2016 to December 2019 were extracted from the NIS. Logistic regressions analysed relationships between HF and in-hospital mortality, length of stay >4 days, thrombectomy, thrombolysis, and complications at discharge adjusted for age and comorbidities. Additional models examined interactions between HF and sex, and HF and race/ethnicity. Results: Among 1,744,390 AIS hospitalizations, 16.36% had HF. 69.00% were White, 17.86% Black, 7.42% Hispanic, 2.79% Asian. No significant sex or racial/ethnic differences were found for in-hospital mortality. Patients with co-morbid HF had increased odds of complications at discharge in both sexes (odds ratio (95% confidence interval) 1.32 (1.27–1.37) in women and 1.21 (1.17–1.25) in men). HF (cf. no HF) showed stronger associations with increased complications at discharge in White (1.36 (1.32–1.40)) patients, compared to other racial/ethnic groups (Black 1.08 (1.03–1.13), Hispanic 1.10 (1.01–1.20), and Asian 1.13 (0.97–1.32)). HF was not significantly associated with thrombolysis in White patients (0.98 (0.95–1.02)) but was in Black (1.20 (1.13–1.28)), Hispanic (1.27 (1.14–1.40)), and Asian (1.36 (1.14–1.62)). Additionally controlling socioeconomic variables did not change the relationships except in Hispanic patients for complications, which has become insignificant (1.07 (0.98–1.17)). Conclusions: The association between HF and post-stroke outcomes differs by race/ethnicity and sex, even when adjusting for key predictors of outcomes. Further research is required to identify the drivers of these disparities.
Al-Batat et al. (Mon,) studied this question.