Abstract TMP75: Clinical Care and Outcomes of Asian Acute Ischemic Stroke Patients
Bibliographic record
Abstract
Introduction: Though overall stroke incidence and mortality in U.S. is improving, little is known about the state of stroke care and trends over time in Asian-Americans. Methods: We abstracted clinical characteristics, treatment patterns, and outcomes from acute ischemic stroke admissions for Asian-American and White patients from 4/1/04-7/31/16 from 2,171 hospitals in Get With The Guidelines-Stroke. Multivariable regression models assessed association of Asian ethnicity and outcomes that adjusted for patient and hospital characteristics and NIHSS. Results: Study population (N=1,772,299) had 64,337 Asian-American patients (3.6%) and 1,707,962 White patients; mean age 72.4, 51.3% female. Asians had greater stroke severity than Whites (Table). After adjustment, Asians had greater stroke severity, higher in-hospital mortality, poorer functional recovery, received IVtPA less but had more serious and hemorrhagic complications, despite being more likely to receive IV tPA<60 min. After NIHSS adjustment, Asians had lower in-hospital mortality than Whites. Adjusted analyses of time trends revealed statistically significant increasing trend on IVtPA usage, decreased symptomatic ICH post-TPA, decreased in-hospital mortality, and improved QOC measures in both Asians and Whites. Both Asians and Whites had an increasing trend on IVtPA within 60 min, and Asians had significant larger increasing trend compared to Whites. Trend analyses also showed only Whites had decreasing trend on stroke severity and increasing trend on discharge home. Conclusions: This is the largest analysis of clinical and functional outcomes for Asian-American acute ischemic stroke patients. Asian-Americans have more severe ischemic strokes, worse functional outcomes, and receive less IVtPA than White patients. These findings warrant additional research, and more dedicated interventions towards improving clinical outcomes for Asian-American patients with acute ischemic stroke.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".