Declining Treatment Gaps in the United States
Sohei Yoshimura, MD, PhD
Otite FO, Saini V, Sur NB, Patel S, Sharma R, Akano EO, Anikpezie N, Albright K, Schmidt E, Hoffman H, et al. Ten-Year Trend in Age, Sex, and Racial Disparity in tPA (Alteplase) and Thrombectomy Use Following Stroke in the United States. Stroke. 2021;52:2562-2570.
Stroke is a common disease, but there have been reports of common stroke treatment disparities related to several factors, such as age, gender, and race. This study evaluated national trends in age-, sex-, and race-specific use of IV tPA and mechanical thrombectomy (MT), the most important quality indicators for standardized stroke treatment. The data was obtained from National Inpatients Samples (NIS), the largest publicly available inpatient healthcare database in the United States. The authors used ICD-9-CM and ICD-10-MC/procedure coding system to identify exposures and outcomes. This study revealed that the overall frequency of IV tPA and MT utilization in the U.S. increased in all age, sex, and race groups over the last decade. The pace of the increase was more pronounced in ≥80 year old patients and in Black and Hispanic patients, leading to a decline in age- and race-associated treatment gaps over time. The faster increase of IV rPA usage in women also led to narrowing of sex-related treatment gaps.