Asian Americans suffer higher in-patient mortality following sub-arachnoid hemmorhage

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1. Within the NIS sample, Asian patients had significantly higher risk of in-patient mortality following sub-arachnoid hemorrhage (SAH) than all other ethnic groups. 

2. Within the NIS sample, Black patients had significantly higher risk of discharge to institutional care following SAH than all ethnic groups. 

Evidence Rating Level: 3 (Average)        

Study Rundown: This study was the first comprehensive database driven study to demonstrate to demonstrate clear differences in outcomes following SAH along racial/ethic lines. The study backed up previous findings that there was no mortality difference between blacks and whites, though black patients in this study were more likely to be discharged to institutional care than all other ethnicities. The study also found Hispanics to be at lower risk of mortality than other ethnicities despite having higher associated risk factors, another finding corroborated in previous literature. Asian/Pacific Islander (API) patients had the higher rates of mortality, a finding thought to be attributed to numerous factors including: APIs having more severe SAH, less access to high quality facilities, cultural/language barriers, and the heterogeneous nature of those within the API designation.

Click to read the study in JNS

Relevant Reading: Racial differences in demographics, acute complications, and outcomes in patients with subarachnoid hemorrhage: a large patient series

In-Depth [cross-sectional study]: This study utilized the National Inpatient Sample database of hospital discharges nationwide from 2005-2010. Discharges with an ICD-9-CM diagnosis code of SAH were studied to compare outcomes of in-patient mortality and discharge to institutional care by race. Black patients had similar mortality as white patients, but were more likely to be discharged to institutional care (OR 1.27, 95% CI 1.14-1.40). Hispanic patients had significant lower risk of mortality than white patients (OR 0.84, 95% CI 0.72-0.97). Finally, API patients were at a significantly higher risk of in-patient death compared to white patients (OR 1.34, 95% CI 1.13-1.59).

By Allen Ho

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