CINCINNATI— New research from the University of Cincinnati reveals that while long-term survival rates following strokes are generally improving, Black individuals continue to face worse outcomes compared to white individuals. The findings were published on Monday in the medical journal of the American Academy of Neurology.
Dr. David Robinson, the corresponding author of the study, emphasized that previous research primarily focused on short-term stroke outcomes, typically examining periods of 30 or 60 days. This new study, however, analyzed survival rates up to five years after a stroke.
“This was the first attempt to look at a much longer period of follow-up time after a stroke, since a lot of the interventions we’ve come up with have more effect long term than they do in the short term,” said Robinson, a physician-researcher at the UC Gardner Neuroscience Institute and an assistant professor in the Department of Neurology and Rehabilitation Medicine at UC’s College of Medicine. “We’ve never been able to show that outcomes from strokes were definitively improving over longer periods of time.”
The research utilized data from the Greater Cincinnati Northern Kentucky Stroke Study, which has been tracking stroke epidemiology in a five-county region since 1993. Robinson noted that this area reflects the broader demographics of the United States in terms of race, educational attainment, and socioeconomic status.
Among patients with acute ischemic stroke, the most common type of stroke, five-year mortality rates improved from 53% in 1993-94 to 48.3% in 2015—an absolute decline nearly double what would be expected in the general population. However, there were no changes in five-year survival rates for patients following an intracerebral hemorrhage, the most severe type of stroke.
“For the first time, we saw that there clearly has been an improvement in five-year mortality after stroke, and it probably is at least partially driven by the stroke systems of care that have been set up here in Cincinnati,” Robinson said. “The data suggests that we have specific interventions in the care of stroke that are disproportionately improving mortality for that particular group of people.”
Despite overall improvements, the study found that Black individuals were 20% more likely to die within five years after an ischemic stroke compared to white individuals. While it is well-documented that strokes are more common among Black individuals, this research highlights for the first time that their long-term outcomes are also worse.
Robinson explained that the overall improvement in mortality is likely due to a combination of new treatments and a more comprehensive system of stroke care. Conversely, various long-term social, economic, and environmental inequities likely contribute to the poorer outcomes for Black patients.
Looking ahead, Robinson emphasized the importance of ongoing follow-up and monitoring of stroke patients to further improve long-term survival, particularly among Black patients. This includes ensuring patients are on the right medications to minimize the risk of additional strokes, managing cholesterol levels, and controlling blood pressure.
Additionally, the increase in stroke survival rates means that more people are living with disabilities caused by their strokes, underscoring the need for enhanced rehabilitation services, such as those offered at UC’s Stroke Recovery Clinic.
“If we’re helping people survive more, we’re going to have to come up with better treatments to help them with their disability, and that’s a big focus of our rehab group here, which I think is critical,” Robinson said. “I don’t think there’s any way you can look at this data and not be concerned about the number of people who are going to be surviving and need some help in terms of getting them as functional as we can.”
