{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T02:36:21Z","timestamp":1783132581306,"version":"3.54.6"},"reference-count":54,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: This analysis was conducted as a part of a quality improvement project aiming at identifying racial disparity in inpatient stroke quality of care. Methods: The Get With The Guidelines (GWTG) database was used to identify all patients discharged with any stroke diagnosis between January and December 2021. An additional chart review was conducted to ensure the accuracy of racial\/ethnic categorization. The sample was dichotomized into white vs. non-white groups and compared with univariate analysis. Results: The study sample comprised 1408 encounters (1347 patients) with Mean age of 71 \u00b1 15 years, 51% women, 82% white patients, 15% non-white patients, 72% acute ischemic stroke (AIS); 15% transient ischemic attack (TIA), 9% intracerebral hemorrhage (ICH), 3% subarachnoid hemorrhage (SAH), and 1% stroke not otherwise specified. Non-white patients were younger and had fewer concomitant diagnoses, a lower proportion of TIA, and a higher proportion of ICH (p = 0.004). In the AIS cohort, compared to white patients, non-white patients had less frequent ambulance (p = 0.009), arrived at the hospital later than white patients (7.7 h longer; p &lt; 0.001), had more severe strokes, and had less frequent IV thrombolysis utilization (7% vs. 13%; p = 0.042). Similarly, in the TIA cohort, non-white patients\u2019 utilization of EMS was lower than that of white patients, and their hospital arrival was delayed. In the ICH cohort, non-white patients were younger and had a lower frequency of atrial fibrillation and a non-significant trend toward higher disease severity. The SAH cohort had only eight non-white patients, six of whom were transferred to a higher level of hospital care within a few hours of arrival. Importantly, the hospital-based quality metrics, such as door-to-CT time, door-to-needle time, and the Joint Commission stroke quality metrics, were similar between the two groups. Conclusions: There is a racial disparity in the pre-hospital phase of the stroke chain of survival of non-white patients, impacting IV thrombolysis utilization. The younger age and worse lipid profile and hemoglobin A1c of non-white patients suggest the need for better preventative care starting at a young age.<\/jats:p>","DOI":"10.3390\/jcm12247654","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T08:55:16Z","timestamp":1702457716000},"page":"7654","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Racial Impact on Inpatient Stroke Quality of Care in Two Community Hospitals"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8051-2759","authenticated-orcid":false,"given":"Haitham M.","family":"Hussein","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai-Kau","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5545-3803","authenticated-orcid":false,"given":"Solmaz","family":"Ramezani","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6929-8325","authenticated-orcid":false,"given":"Omair ul haq","family":"Lodhi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaroslav","family":"Owens-Pochinka","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinci","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2833-9503","authenticated-orcid":false,"given":"Ahmed","family":"Elbokl","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University of Minnesota, Minneapolis, MN 55455, USA"},{"name":"Department of Neurology, Ain Shams University, Cairo 11517, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"ref_1","first-page":"e464","article-title":"Twenty-Year Disparity Trends in United States Stroke Death Rate by Age, Race\/Ethnicity, Geography, and Socioeconomic Status","volume":"101","author":"Zhou","year":"2023","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e025903","DOI":"10.1161\/JAHA.122.025903","article-title":"Demographic and Regional Trends in Stroke-Related Mortality in Young Adults in the United States, 1999 to 2019","volume":"11","author":"Ariss","year":"2022","journal-title":"J. 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