Stroke: The basis of chronic diseases, or explain the differences in the prognosis of stroke in different races

In the United States, the impact of stroke on ethnic minorities is disproportionate
.

Hispanics are now the largest minority group in the United States

These racial differences are not fully explained by demographics, socioeconomic status, risk factors, stroke severity, and post-stroke mortality of different races
.

The increased risk of stroke and post-stroke disability, prolonged survival, and rapid growth of the MA population will all increase the burden of care for MA stroke survivors.

Stroke Therefore, it is necessary to further investigate the driving factors of racial differences in FO after stroke

Congestive heart failure (CHF), diabetes , chronic kidney disease, malnutrition and pre-existing diseases of the nervous system have been found that may affect the FO through specific physiological pathways stroke pathology, the overall consumption of these diseases may be common heart blood vessels reserves or damage help Neuroplasticity recovered after stroke
.

Diabetes, heart blood vessels

However, studies on MCC and FO in different populations are lacking, and the role of MCC in racial differences in FO is not well understood
.

Research on MCC and FO in different populations is lacking, and the role of MCC in racial differences in FO is not well understood
.

The MCC profile of MA stroke patients is different from that of NHWs, and the role of MCC in FO may vary by race
.

Compared with NHWs, patients with MA stroke are more likely to have hypertension, diabetes, and previous strokes or transient ischemic attacks, but are less likely to have atrial fibrillation and coronary artery disease

Previous studies did not find a difference in the number of comorbidities between MA and NHW stroke patients
.

However, because the incidence of specific comorbidities varies from race to race, the simple sum of the disease conditions cannot fully reflect the racial differences in the MCC spectrum, nor can it reflect that some conditions may be more important than others in predicting FO
.

In addition, MAs may have more obstacles in the treatment of MCC,

Therefore, compared with NHWs, there are more uncontrolled illnesses or more serious illnesses, which raises the possibility that the influence of MCC on FO varies by race
.

In order to comprehensively measure MCC, Xiaqing Jiang and others of the University of Michigan have previously developed and internally verified a new ischemic stroke MCC index, which takes into account chronic diseases, pre-stroke function and cognitive impairment, and synergistic effects
.

These important predictors of FO after stroke were selected through machine learning techniques

In terms of predicting FO after 90 days, the index score alone and together with the initial stroke severity and age outperformed the main index, the modified Charlson comorbidity index
.

The purpose of this study is to use the new MCC index to understand the contribution of MCC to the racial difference in FO within 90 days of MA and NHW ischemic stroke patients

They collected data from patient interviews, medical records, and discharge data in a prospective cohort (2008-2016) of patients with ischemic stroke in Nueces County, Texas
.

Use stroke-specific and function-related indexes to assess MCC (range, 0-35; the higher the score, the greater the burden of MCC)

Compared with non-Hispanic whites, the age-adjusted MCC burden of MAs is significantly higher
.
After adjusting for age, the original National Institutes of Health Stroke Scale, and sociodemographic factors, patients with high MCC scores (75th percentile) compared with patients with low MCC scores (25th percentile) The FO score is 0.
70 points higher on average (indicating that FO is worse)
.

Compared with non-Hispanic whites, the age-adjusted MCC burden of MAs is significantly higher
.

MCC explained 19% of the racial difference in FO, and the effect of race was not statistically significant
.

The important significance of this study lies in the discovery: The age-adjusted MCC burden of MAs is higher, which partly explains the racial difference in FO
.
Prevention and treatment of MCC may reduce the dysfunction after stroke and reduce the ethnic difference in stroke outcome
.

The age-adjusted MCC burden of MAs is higher, which partly explains the prevention of racial differences in FO

Original Source:
Jiang X, Morgenstern LB, Cigolle CT, Wang L, Claflin ES, Lisabeth LD.
Multiple Chronic Conditions Explain Ethnic Differences in Functional Outcome Among Patients With Ischemic Stroke .
Stroke.
Published online September 14, 2021.
doi:10.
1161/STROKEAHA .
120.
032595

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