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Epidemiologic studies can provide important insights into changes in the societal impact of diseases, geographic variations in incidence and prevalence, their association with sociodemographic factors, and the potential impact of disease risk factors and the effectiveness of treatments. For stroke, examples include the Framingham Study,(1) the Northern Manhattan Stroke Study,(2) the Reasons for Geographic and Racial Differences in Stroke study,(3) the Brain Attack Surveillance in Corpus Christi project,(4) and the Atherosclerosis Risk in Communities (ARIC) cohort study,(5) to list a few. In this issue of Neurology (R), using data from another population-based epidemiologic project, the Greater Cincinnati Northern Kentucky (GCNK) study, Robinson et al. reported on temporal trends and racial disparities in mortality over 5 years after stroke occurring in July 1993 to June 1994 and during 1999, 2005, 2010, and 2015 (8,428 cases of acute ischemic stroke [AIS] and 1,501 cases of parenchymal intracerebral hemorrhage [ICH]).(6) After adjustment for age, race, and sex, there was an 8.9% reduction in 5-year mortality after AIS between 1993/94 and 2015 (53% mortality rate declining to 48.3%; p = 0.009) with no reduction in death after ICH (64.4% vs 69.2%, respectively; p = 0.32). After adjustment for age and sex, Black patients had a consistent 23% higher 5-year mortality after AIS compared with Whites (OR 1.23, 95% CI 1.08-1.39) with the difference attenuating after adjustment for sex, premorbid functional status, and comorbidities. Although overall 5-year mortality after AIS declined over the study period, the disparity between Blacks and Whites persisted.
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8.5
论文数:
3.5W
被引数:
9.8W
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