Racial disparities in refusal of stroke thrombolysis in Chicago

摘要: Objective To evaluate race differences in tissue plasminogen activator (tPA) refusal among eligible patients with acute ischemic stroke (AIS) Chicago. Methods Using the Get With The Guidelines–Stroke registry data from 15 primary centers between January 2013 and June 2015, we performed a retrospective analysis of AIS presenting to emergency department within 4.5 hours symptom onset. Patient or proxy was captured as reason for nonadministration tPA registry. We assessed whether differed by using logistic regression. Results Among 704 tPA-eligible AIS, administered 86.2% (black race, 82.5% vs nonblack 89.5%; p = 0.004). In multivariable analysis, following were associated refusal: black (adjusted odds ratio [OR] 2.5, 95% confidence interval [CI] 1.3–4.6), self-pay status OR 3.23, CI 1.2–8.71), prior 2.11, 1.14–3.90), age 1.04, 1.02–1.07), NIH Stroke Scale score 0.94, 0.90–0.99). Conclusions Chicago, over 7% refused tPA. Refusal more common accounted apparent lower rates use patients. Further research is needed understand barriers consent overcome race–ethnic disparities treatment AIS.