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April 12, 2023Clinical/Scientific Note

Stroke Outcomes Among English- and Spanish-Speaking Mexican Americans

Alejandro Vargas, Guanghao Zhang, View ORCID ProfileXu Shi, Lynda D. Lisabeth, View ORCID ProfileLewis B. Morgenstern
First published April 12, 2023, DOI: https://doi.org/10.1212/WNL.0000000000207275
Alejandro Vargas
1Rush University Medical Center, Department of Neurological Sciences, Chicago, IL
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Guanghao Zhang
2Department of Biostatistics, University of Michigan School of Public Health
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Xu Shi
2Department of Biostatistics, University of Michigan School of Public Health
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Lynda D. Lisabeth
3Stroke Program, Michigan Medicine and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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Lewis B. Morgenstern
3Stroke Program, Michigan Medicine and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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  • ORCID record for Lewis B. Morgenstern
  • For correspondence: lmorgens@umich.edu
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Stroke Outcomes Among English- and Spanish-Speaking Mexican Americans
Alejandro Vargas, Guanghao Zhang, Xu Shi, Lynda D. Lisabeth, Lewis B. Morgenstern
Neurology Apr 2023, 10.1212/WNL.0000000000207275; DOI: 10.1212/WNL.0000000000207275

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Abstract

Objectives: We examined whether language preference was associated with 90-day post stroke outcomes among Mexican Americans (MAs).

Methods: Ischemic stroke and intracerebral hemorrhage (ICH) patients from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) project (2009-2018) were compared by language preference in 90-day neurological, functional and cognitive outcomes using weighted Tobit regression. Models were adjusted for demographics, initial NIHSS, medical history, stroke characteristics, and insurance status.

Results: Of 1,096 stroke patients, 926 were English-speaking and 170 were Spanish only speaking. Spanish speakers were older (p < 0.01), received less education (p < 0.01), had higher initial NIHSS values (p = 0.02), had higher prevalence of atrial fibrillation (p < 0.01), and had lower prevalence of smoking (p = 0.01) than English speakers. In fully adjusted models, Spanish only speakers had worse neurological outcome (NIHSS, range 0–44 [higher worse], mean difference: 1.93, p < 0.01), but no difference in functional outcome measured by activities of daily living/instrumental activities of daily living or cognitive outcome compared with English speakers.

Conclusions: This population-based study found worse neurologic but similar functional and cognitive stroke outcomes among Spanish only speaking MAs compared with English speaking MAs.

  • Received September 22, 2022.
  • Accepted in final form February 23, 2023.
  • © 2023 American Academy of Neurology

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  • Equity, Diversity, and Inclusion (EDI)
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