Blacks, men, youth more likely to receive neuroimaging

Patients admitted to the hospital for a stroke are more likely to receive neuroimaging if they are black, male or aged younger than 55 years, according to data presented at the American Society of Neuroradiology’s 2016 annual meeting.

“Rates of diagnostic workup in stroke have increased over time,” Achala Vagal, MD, of the University of Cincinnati College of Medicine, who led the researchers, said in a press release. “However, less is known about differences in utilization of neuroimaging for stroke from a population perspective. In this study, we found that age, sex and race do matter as far as neuroimaging use is concerned.”

To determine whether age, sex or race mattered regarding neuroimaging use, Vagal and colleagues analyzed data from the Greater Cincinnati/Northern Kentucky Stroke Study. This NIH-funded study included cases from hospitals, clinics, coroners’ offices, nursing homes and physician offices from a representative, five-county area. The researchers focused on patient charts and imaging records for those admitted for stroke in the years 2005 and 2010. They then calculated the proportion of use, within 2 days of the stroke or hospital admission, of head CT without contrast, head MRI, CT angiogram, MR angiogram and carotid ultrasound.

In all, the researchers were able to analyze 3,471 stroke or mini-stroke events with corresponding imaging data in 3,226 patients in 2005. For 2010, they analyzed 3,431 stroke or mini-stroke events with imaging data, representing 3,213 patients.

According to the researchers, there was a higher proportion of males receiving MRI — 55% vs. 51% — and MR angiogram — 36% vs. 31% — compared with females in both 2005 and 2010, with no sex differences in the use of the other imaging techniques. In addition, a higher proportion of black patients received head CT imaging without contrast — 96% vs. 92% — MRI — 59% vs. 51% — and MR angiogram — 41% vs. 31% — compared with white patients, with no racial differences in use of the other techniques.

In addition, the researchers found that use of all imaging techniques, except CT without contrast and carotid ultrasound, was higher in patients younger than 55 years, compared with patients who were older. The likelihood of receiving advanced imaging was higher among patients younger than 55 years, black patients, and patients who came to an academic center or were seen by a stroke team or neurologist.

“The differences discovered in this study may be partly driven by age, with younger patients getting more extensive workups and partly by access to stroke expertise,” Vagal said in a press release. “However, further understanding of the contributors can provide an important basis for newer lines of inquiry into environmental, socioeconomic and access to health care issues.” – by Jason Laday

Disclosure: Healio Family Medicine was unable to confirm the researchers’ relevant financial disclosures.

Reference:

Vagal A, et al. Presented at: American Society of Neuroradiology Annual Meeting; May 25, 2016; Washington, D.C.