Abstract Body: Introduction:
Patient reported outcomes post-stroke may be more sensitive to meaningful differences than the modified Rankin Scale (mRS). We aimed to compare patient reported outcomes (PROMs) in Mexican Americans (MAs) and non-Hispanic Whites (NHWs) in a community-based study. We also explored the correlation of PROMs with the mRS at 3 months post-stroke.
Methods:
All patients with ischemic and hemorrhagic stroke (ICH) from mid 2019-2023 in the Brain Attack Surveillance in Corpus Christi (BASIC) project were enrolled. PROMs and mRS were assessed at 3 months post-stroke. PROMs were assessed by the Patient-Reported Outcomes Measurement Information System, (PROMIS), Work and Social Adjustment Scale (WSAS), Economic Quality of Life Survey (EQOL) and ability to return to work and driving.
For unadjusted analyses, medians and IQRs were reported for continuous and ordinal variables, with t-test p-values. Chi-squared tests were used for binary variables. For adjusted models, logistic, multinomial, or proportional-odds cumulative logit models were used as appropriate. Multitier inverse probability weighting (IPW) addressed sample attrition, and covariates included age, sex, initial NIHSS, comorbidity count, ischemic vs ICH, and previous stroke.
Results:
A total of 913 patients were included. Table 1 provides the main results. In the adjusted analysis, MA had significantly lower (worse) PROMIS Global Mental Health score (mean ethnic difference: -2.24, 99% CI: -3.93 to -0.54, p<0.01) and (worse) WSAS score (pOR: 2.15 99% CI 1.48 to 3.12, p<0.01) vs NHWs. On EQOL, MA were significantly less likely to have enough income to meet needs (p<0.01), enough income to pay bills (p<0.01), more likely to delay health care (p<0.01), and less likely to always afford personal care (p<0.01) vs NHWs. MA were significantly less likely to return to driving (OR 0.56 99% CI 0.34 to 0.90, p<0.01) vs NHWs. PROMIS scores were moderately correlated with mRS at 3 months (Table 2).
Conclusions:
MA have significantly worse long-term PROMs when compared to NHWs and PROMs are not very highly correlated with mRS. Efforts to understand the etiology of these ethnic differences are needed. This data supports the need to collect PROMs in stroke patients.