{"id":3261,"date":"2020-04-13T00:00:00","date_gmt":"2020-04-13T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/association-between-immigration-status-and-acute-stroke-care-a-retrospective-study\/"},"modified":"2023-06-14T19:55:20","modified_gmt":"2023-06-14T23:55:20","slug":"association-between-immigration-status-and-acute-stroke-care-a-retrospective-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-immigration-status-and-acute-stroke-care-a-retrospective-study\/","title":{"rendered":"Association between immigration status and acute stroke care: a retrospective study"},"content":{"rendered":"<p><span class=\"bold\">Background and Purpose <\/span>&#x2014; Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is known about the care and outcomes of stroke in immigrants.<\/p>\n<p><strong>Methods <\/strong>&#x2014; We used linked clinical and administrative data to conduct a retrospective cohort study of adults seen in the emergency department or hospitalized with ischemic stroke or transient ischemic attack between July 1, 2003, and April 1, 2013, and included in the provincial stroke registry. We ascertained immigration status using immigration records and compared processes of stroke care delivery between immigrants (defined as those immigrating after 1985) and long-term residents. In the subgroup with ischemic stroke, we calculated inverse probability treatment weight (IPTW)&#x2013;adjusted risk ratios for disability on discharge (modified Rankin Scale score of 3 to 5), accounting for demographic characteristics and comorbid conditions to compare outcomes between immigrants and long-term residents.<\/p>\n<p><strong>Results <\/strong>&#x2014; We included 34 987 patients with ischemic stroke or transient ischemic attack, of whom 2649 (7.6%) were immigrants. Immigrants were younger than long-term residents at the time of stroke\/transient ischemic attack (median age 67 years versus 76 years; P&lt;0.001). In the subgroup with ischemic stroke, there were no differences in stroke care delivery, except that a higher proportion of immigrants received thrombolysis than long-term residents (21.2% versus 15.5%; P&lt;0.001). Immigrants with ischemic stroke had a higher adjusted risk of being disabled on discharge (adjusted risk ratio, 1.18; 95% CI, 1.13&#x2013;1.22) compared to long-term residents.<\/p>\n<p><strong>Conclusions <\/strong>&#x2014; Stroke care is similar in Canadian immigrants and long-term residents. Future research is needed to confirm the observed association between immigration status and disability after stroke and to identify factors underlying the association.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background and Purpose &#x2014; Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is known about the care and outcomes of stroke in immigrants. Methods &#x2014; We used linked clinical and administrative data to conduct a retrospective cohort study of adults seen in the emergency department or hospitalized [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3261","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Vyas MV, Laupacis A, Austin PC, Fang J, Silver FL, Kapral MK. <em>Stroke<\/em>. 2020; 51(5):1555-62. Epub 2020 Apr 13.","source_url":"https:\/\/doi.org\/10.1161\/STROKEAHA.119.027791 ","ices_scientist":[1385,1375,1150,1293,1118],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"565A868E-DF9E-44A9-991D-A96F43357949","sitecore_item_name":"Association-between-immigration-status-and-acute-stroke-care","sitecore_field_values":"{\n  \"Title\": \"Association between immigration status and acute stroke care: a retrospective study\",\n  \"Short title\": \"Association between immigration status\",\n  \"Summary\": \"Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is known about the care and outcomes of stroke in immigrants.\",\n  \"Citation\": \"<p>Vyas MV, Laupacis A, Austin PC, Fang J, Silver FL, Kapral MK. <em>Stroke<\/em>. 2020; 51(5):1555-62. Epub 2020 Apr 13. DOI: <a href=\"https:\/\/doi.org\/10.1161\/STROKEAHA.119.027791 \" title=\"Opens external link\">https:\/\/doi.org\/10.1161\/STROKEAHA.119.027791<\/a><\/p>\",\n  \"Abstract\": \"<p><span class=\"bold\">Background and Purpose <\/span>&mdash; Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is known about the care and outcomes of stroke in immigrants.<\/p>n<p><strong>Methods <\/strong>&mdash; We used linked clinical and administrative data to conduct a retrospective cohort study of adults seen in the emergency department or hospitalized with ischemic stroke or transient ischemic attack between July 1, 2003, and April 1, 2013, and included in the provincial stroke registry. We ascertained immigration status using immigration records and compared processes of stroke care delivery between immigrants (defined as those immigrating after 1985) and long-term residents. In the subgroup with ischemic stroke, we calculated inverse probability treatment weight (IPTW)&ndash;adjusted risk ratios for disability on discharge (modified Rankin Scale score of 3 to 5), accounting for demographic characteristics and comorbid conditions to compare outcomes between immigrants and long-term residents.<\/p>n<p><strong>Results <\/strong>&mdash; We included 34 987 patients with ischemic stroke or transient ischemic attack, of whom 2649 (7.6%) were immigrants. Immigrants were younger than long-term residents at the time of stroke\/transient ischemic attack (median age 67 years versus 76 years; P&lt;0.001). In the subgroup with ischemic stroke, there were no differences in stroke care delivery, except that a higher proportion of immigrants received thrombolysis than long-term residents (21.2% versus 15.5%; P&lt;0.001). Immigrants with ischemic stroke had a higher adjusted risk of being disabled on discharge (adjusted risk ratio, 1.18; 95% CI, 1.13&ndash;1.22) compared to long-term residents.<\/p>n<p><strong>Conclusions <\/strong>&mdash; Stroke care is similar in Canadian immigrants and long-term residents. Future research is needed to confirm the observed association between immigration status and disability after stroke and to identify factors underlying the association.<\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{BA7F184D-0B54-4C38-827F-77223D5A2AC7}|{85A20A85-A5DB-4EC9-A9C2-DDBB2DEDBF72}|{83920C20-06BE-4C6B-9FA7-06B69A509A24}|{A427077E-906B-463B-8DC1-8DB109670483}\",\n  \"Posted Date\": \"20200413T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2020\/April\/Association-between-immigration-status-and-acute-stroke-care"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association between immigration status and acute stroke care: a retrospective study<\/title>\n<meta name=\"description\" content=\"Background and Purpose &#x2014; Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-immigration-status-and-acute-stroke-care-a-retrospective-study\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Association between immigration status and acute stroke care: a retrospective study\" \/>\n<meta property=\"og:description\" content=\"Background and Purpose &#x2014; Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-immigration-status-and-acute-stroke-care-a-retrospective-study\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:55:20+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-immigration-status-and-acute-stroke-care-a-retrospective-study\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-immigration-status-and-acute-stroke-care-a-retrospective-study\\\/\",\"name\":\"ICES | Association between immigration status and acute stroke care: a retrospective study\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2020-04-13T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:55:20+00:00\",\"description\":\"Background and Purpose &#x2014; 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