Comparing the Use of Diagnostic Imaging and Receipt of Carotid Endarterectomy in Elderly Black and White Stroke Patients

Martin KD, Naert L, Goldstein LB, et al (Yale School of Public Health, New Haven, CT; Iowa Foundation for Med Care, West Des Moines; Duke Univ and VA Med Ctr, Durham, NC) J Stroke Cerebrovasc Dis 21:600-606, 2012^§

Abstract

Background

Previous studies show that black patients undergo carotid endarterectomy (CEA) less frequently than white patients. Diagnostic imaging is necessary to determine whether a patient is a candidate for the operation. We determined whether there were differences in the use of diagnostic carotid imaging and the frequency of CEA between elderly black and white ischemic stroke patients.

Methods

Medicare fee-for-service beneficiaries with discharge diagnoses of ischemic stroke (International Classification of Diseases, 9th revision codes 433, 434, and 436) were randomly selected for inclusion in the National Stroke Project 1998-1999, 2000-2001. Receipt of at least one type of carotid imaging study was compared for black and white patients. Binomial logistic regression models were used to evaluate the associations between race and receipt of carotid imaging and CEA with adjustment for demographics, degree of carotid artery stenosis, and other clinical covariates.

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