RT Journal Article
SR Electronic
T1 Age, Sex, and Racial Differences in Neuroimaging Use in Acute Stroke: A Population-Based Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1905
OP 1910
DO 10.3174/ajnr.A5340
VO 38
IS 10
A1 A. Vagal
A1 P. Sanelli
A1 H. Sucharew
A1 K.A. Alwell
A1 J.C. Khoury
A1 P. Khatri
A1 D. Woo
A1 M. Flaherty
A1 B.M. Kissela
A1 O. Adeoye
A1 S. Ferioli
A1 F. De Los Rios La Rosa
A1 S. Martini
A1 J. Mackey
A1 D. Kleindorfer
YR 2017
UL http://www.ajnr.org/content/38/10/1905.abstract
AB BACKGROUND AND PURPOSE: Limited information is available regarding differences in neuroimaging use for acute stroke work-up. Our objective was to assess whether race, sex, or age differences exist in neuroimaging use and whether these differences depend on the care center type in a population-based study.MATERIALS AND METHODS: Patients with stroke (ischemic and hemorrhagic) and transient ischemic attack were identified in a metropolitan, biracial population using the Greater Cincinnati/Northern Kentucky Stroke Study in 2005 and 2010. Multivariable regression was used to determine the odds of advanced imaging use (CT angiography/MR imaging/MR angiography) for race, sex, and age.RESULTS: In 2005 and 2010, there were 3471 and 3431 stroke/TIA events, respectively. If one adjusted for covariates, the odds of advanced imaging were higher for younger (55 years or younger) compared with older patients, blacks compared with whites, and patients presenting to an academic center and those seen by a stroke team or neurologist. The observed association between race and advanced imaging depended on age; in the older age group, blacks had higher odds of advanced imaging compared with whites (odds ratio, 1.34; 95% CI, 1.12–1.61; P < .01), and in the younger group, the association between race and advanced imaging was not statistically significant. Age by race interaction persisted in the academic center subgroup (P < .01), but not in the nonacademic center subgroup (P = .58). No significant association was found between sex and advanced imaging.CONCLUSIONS: Within a large, biracial stroke/TIA population, there is variation in the use of advanced neuroimaging by age and race, depending on the care center type.GCNKSSGreater Cincinnati/Northern Kentucky Stroke Study