%0 Journal Article
%T Racial/Ethnic Differences in Poststroke Rehabilitation Outcomes
%A Charles Ellis
%A Hyacinth I. Hyacinth
%A Jamie Beckett
%A Wuwei Feng
%A Marc Chimowitz
%A Bruce Ovbiagele
%A Dan Lackland
%A Robert Adams
%J Stroke Research and Treatment
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/950746
%X Background. Significant racial and ethnic disparities in stroke incidence, severity, and morbidity have been consistently reported; however, less is known about potential differences in poststroke rehabilitation outcomes. Objective. To examine racial and ethnic differences in poststroke rehabilitation outcomes. Methods. We completed an in-depth search of Medline and several major journals dedicated to publishing research articles on stroke, rehabilitation, and racial-ethnic patterns of disease over a 10-year period (2003¨C2012). We identified studies that reported rehabilitation outcomes and the race or ethnicity of at least two groups. Results. 17 studies involving 429,108 stroke survivors met inclusion criteria for the review. The majority (94%) of studies examined outcomes between Blacks and Whites. Of those studies examining outcomes between Blacks and Whites, 59% showed that Blacks were generally less likely to achieve equivalent functional improvement following rehabilitation. Blacks were more likely to experience lower FIM gain or change scores (range: 1¨C60%) and more likely to have lower efficiency scores (range: 5¨C16%) than Whites. Conclusions. Black stroke survivors appear to generally achieve poorer functional outcomes than White stroke survivors. Future studies are warranted to evaluate the precise magnitude of these differences, whether they go beyond chance, and the underlying contributory mechanisms. 1. Background Stroke is a leading cause of long-term disability and the fourth leading cause of death in the US [1]. Estimates indicate that ~795,000 Americans experience a stroke each year [1]. Among those are non-Hispanic Blacks (Blacks) who are at twice the risk of first-ever stroke compared to non-Hispanic Whites (Whites) [2]. The age-adjusted risk of ischemic stroke is 0.88 in Whites, 1.49 in Hispanics, and 1.91 in Blacks [3]. Blacks are also more likely to experience a stroke at a younger age and more likely to become disabled and experience difficulties with daily living and activities [2]. Similarly, older Blacks and Hispanics are more likely to experience higher odds of one-year all-cause poststroke rehospitalization compared to Whites after adjusting for patient and hospital characteristics [4]. Interestingly, there has been a decrease in ischemic stroke incidence among Whites in the US; however the incidence of overall ischemic stroke among Blacks has remained virtually the same [5]. Studies continue to demonstrate a differential impact of stroke between racial/ethnic groups with minorities experiencing worse poststroke outcomes.
%U http://www.hindawi.com/journals/srt/2014/950746/