Journal article
Impact of Race on Outcomes in the Endovascular and Microsurgical Treatment in Patients With Intracranial Aneurysms
Neurosurgery, Vol.95(4), pp.807-815
10/2024
DOI: 10.1227/neu.0000000000002946
PMID: 38651917
Abstract
The impact of race on outcomes in the treatment of intracranial aneurysm (IA) remains unclear. We aimed to investigate the relationship between race classified into White, Black, Hispanic, and other and treatment outcomes in patients with ruptured and unruptured IAs.
The study population consisted of 2836 patients with IA with endovascular treatment or microsurgical treatment (MST) from 16 centers in the United States and Asia, all participating in the observational "STAR" registry. The primary outcome was a 90-day modified Rankin Scale of 0 to 2. Secondary outcomes included periprocedural cerebral infarction and intracranial hemorrhage, perioperative symptomatic cerebral vasospasm in ruptured IA and mortality, and all causes of mortality within 90 days.
One thousand fifty-three patients were White (37.1%), 350 were Black (12.3%), 264 were Hispanic (9.3%), and 1169 were other (41.2%). Compared with White patients, Hispanic patients had a significantly lower proportion of primary outcome (adjusted odds ratio [aOR] 0.36, 95% CI, 0.23-0.56) and higher proportion of the periprocedural cerebral infarction, perioperative mortality, and all causes of mortality (aOR 2.53, 95% CI, 1.40-4.58, aOR 1.84, 95% CI, 1.00-3.38, aOR 1.83, 95% CI, 1.06-3.17, respectively). Outcomes were not significantly different in Black and other patients. The subgroup analysis showed that Hispanic patients with age ≥65 years (aOR 0.19, 95% CI, 0.10-0.38, interaction P = .048), Hunt-Hess grades 0 to 3 (aOR 0.29, 95% CI, 0.19-0.46, interaction P = .03), and MST (aOR 0.24, 95% CI, 0.13-0.44, interaction P = .04) had a significantly low proportion of primary outcome.
This study demonstrates that Hispanic patients with IA are more likely to have a poor outcome at 90 days after endovascular treatment or MST than White patients. Physicians have to pay attention to the selection of treatment modalities, especially for Hispanic patients with specific factors to reduce racial discrepancies.
Details
- Title: Subtitle
- Impact of Race on Outcomes in the Endovascular and Microsurgical Treatment in Patients With Intracranial Aneurysms
- Creators
- Hidetoshi Matsukawa - Medical University of South CarolinaKazutaka Uchida - Hyogo Medical UniversityMohammad-Mahdi Sowlat - Medical University of South CarolinaSameh Samir Elawady - Medical University of South CarolinaConor Cunningham - Medical University of South CarolinaAli Alawieh - Emory University School of MedicineSami Al Kasab - Medical University of South CarolinaPascal Jabbour - Thomas Jefferson UniversityJustin Mascitelli - The University of Texas Health Science Center at San AntonioMichael R Levitt - University of WashingtonHugo Cuellar - Louisiana State UniversityWaleed Brinjikji - Mayo ClinicEdgar Samaniego - University of IowaJan-Karl Burkhardt - Hospital of the University of PennsylvaniaPeter Kan - The University of Texas Medical Branch at GalvestonW Christopher Fox - Mayo ClinicMark Moss - Washington Regional Medical CenterMohamad Ezzeldin - University of HoustonRamesh Grandhi - University of UtahDavid J Altschul - Albert Einstein College of MedicineAlejandro M Spiotta - Medical University of South CarolinaShinichi Yoshimura - Hyogo Medical UniversitySTAR Registry Investigators
- Resource Type
- Journal article
- Publication Details
- Neurosurgery, Vol.95(4), pp.807-815
- Publisher
- Walters Kluwer Health; PHILADELPHIA
- DOI
- 10.1227/neu.0000000000002946
- PMID
- 38651917
- ISSN
- 0148-396X
- eISSN
- 1524-4040
- Grant note
- NA / Stryker NA / Medtronic NA / Penumbra
- Language
- English
- Electronic publication date
- 04/23/2024
- Date published
- 10/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984618502102771
Metrics
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