TitleRacial/ethnic variations in acute stroke
NameGezmu, Tefera (author), Schneider, Dona (chair), DEMISSIE, KITAW (internal member), LIN, YONG (internal member), Gizzi, Martin S (outside member), Rutgers University, Graduate School - New Brunswick,
Cerebrovascular disease--New Jersey--Statistics,
Cerebrovascular disease--Risk factors--New Jersey--Statistics,
Cerebrovascular disease--Sex factors--New Jersey--Statistics,
Race--Health aspects--New Jersey--Statistics,
Ethnicity--Health aspects--New Jersey--Statistics
DescriptionThe burden of stroke is well understood for whites, blacks and Hispanics in the United States, yet its nature, outcome, and medical care profiles have not been examined for other immigrant groups, including South Asians. Previous studies on gender differences document higher stroke incidence rates for men but worse outcomes for women. Factors related to stroke hospitalization have been shown to include failure to identify symptoms of stoke onset, delay in emergency department arrival or extended waiting time, and lack of insurance coverage. This dissertation asks whether these results can be further understood by examining stroke data among a multiracial/multiethnic cohort. Specifically it asks: (1) whether racial/ethnic-specific risk factors allow the prediction of subtypes of stroke; that is, large versus small vessel stroke, (2) whether total cholesterol and triglyceride levels can be used as predictors of risk for stroke between genders of the different races/ethnicities, and (3) whether access to emergency care and other health services for stroke differ by race/ethnicity and by stroke type. Stroke registry data were obtained from the New Jersey Neuroscience Institute, John F. Kennedy Medical Center. Data on 3,290 subjects who met the inclusion criteria were examined for socio-demographic, stroke risk, clinical and health profile variables. Results showed that South Asians were younger than whites at the time of admission for acute stroke. Gender comparisons revealed that South Asian and Hispanic men had higher proportions of patients with ischemic stroke than women, while the inverse was true for whites and African Americans. Twice as many young patients (18-44 years) suffered hemorrhagic stroke compared to ischemic stroke. Important predictive factors for stroke outcome included insurance status and use of emergency medical services as a mode of transport to hospitals following stroke symptom recognition. Variations in stroke incidence and outcomes may be partially explained by dietary and life style choices; however consideration must be given to competing morbidity, failure to recognize warning signs for stroke, and failure to use emergency services due to lack of knowledge, language barriers, or lack of insurance. These factors need to be more clearly examined in future studies.
NoteIncludes bibliographical references
Noteby Tefera Gezmu
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.