Age, sex, and racial differences in neuroimaging use in acute stroke

A population-based study

A. Vagal, P. Sanelli, H. Sucharew, K. A. Alwell, J. C. Khoury, P. Khatri, D. Woo, M. Flaherty, B. M. Kissela, O. Adeoye, S. Ferioli, F. De Los Rios La Rosa, S. Martini, Jason Mackey, D. Kleindorfer

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1905-1910
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume38
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Fingerprint

Neuroimaging
Sex Characteristics
Stroke
Population
Transient Ischemic Attack
Angiography
Age Groups
Odds Ratio

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Vagal, A., Sanelli, P., Sucharew, H., Alwell, K. A., Khoury, J. C., Khatri, P., ... Kleindorfer, D. (2017). Age, sex, and racial differences in neuroimaging use in acute stroke: A population-based study. American Journal of Neuroradiology, 38(10), 1905-1910. https://doi.org/10.3174/ajnr.A5340

Age, sex, and racial differences in neuroimaging use in acute stroke : A population-based study. / Vagal, A.; Sanelli, P.; Sucharew, H.; Alwell, K. A.; Khoury, J. C.; Khatri, P.; Woo, D.; Flaherty, M.; Kissela, B. M.; Adeoye, O.; Ferioli, S.; De Los Rios La Rosa, F.; Martini, S.; Mackey, Jason; Kleindorfer, D.

In: American Journal of Neuroradiology, Vol. 38, No. 10, 01.10.2017, p. 1905-1910.

Research output: Contribution to journalArticle

Vagal, A, Sanelli, P, Sucharew, H, Alwell, KA, Khoury, JC, Khatri, P, Woo, D, Flaherty, M, Kissela, BM, Adeoye, O, Ferioli, S, De Los Rios La Rosa, F, Martini, S, Mackey, J & Kleindorfer, D 2017, 'Age, sex, and racial differences in neuroimaging use in acute stroke: A population-based study', American Journal of Neuroradiology, vol. 38, no. 10, pp. 1905-1910. https://doi.org/10.3174/ajnr.A5340
Vagal, A. ; Sanelli, P. ; Sucharew, H. ; Alwell, K. A. ; Khoury, J. C. ; Khatri, P. ; Woo, D. ; Flaherty, M. ; Kissela, B. M. ; Adeoye, O. ; Ferioli, S. ; De Los Rios La Rosa, F. ; Martini, S. ; Mackey, Jason ; Kleindorfer, D. / Age, sex, and racial differences in neuroimaging use in acute stroke : A population-based study. In: American Journal of Neuroradiology. 2017 ; Vol. 38, No. 10. pp. 1905-1910.
@article{1569e212646c41b69d9ae5325d246579,
title = "Age, sex, and racial differences in neuroimaging use in acute stroke: A population-based study",
abstract = "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.",
author = "A. Vagal and P. Sanelli and H. Sucharew and Alwell, {K. A.} and Khoury, {J. C.} and P. Khatri and D. Woo and M. Flaherty and Kissela, {B. M.} and O. Adeoye and S. Ferioli and {De Los Rios La Rosa}, F. and S. Martini and Jason Mackey and D. Kleindorfer",
year = "2017",
month = "10",
day = "1",
doi = "10.3174/ajnr.A5340",
language = "English (US)",
volume = "38",
pages = "1905--1910",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "10",

}

TY - JOUR

T1 - Age, sex, and racial differences in neuroimaging use in acute stroke

T2 - A population-based study

AU - Vagal, A.

AU - Sanelli, P.

AU - Sucharew, H.

AU - Alwell, K. A.

AU - Khoury, J. C.

AU - Khatri, P.

AU - Woo, D.

AU - Flaherty, M.

AU - Kissela, B. M.

AU - Adeoye, O.

AU - Ferioli, S.

AU - De Los Rios La Rosa, F.

AU - Martini, S.

AU - Mackey, Jason

AU - Kleindorfer, D.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - 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.

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.

UR - http://www.scopus.com/inward/record.url?scp=85031733618&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031733618&partnerID=8YFLogxK

U2 - 10.3174/ajnr.A5340

DO - 10.3174/ajnr.A5340

M3 - Article

VL - 38

SP - 1905

EP - 1910

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 10

ER -