Racial/ethnic differences in stroke mortality in veterans

Objective: We examined racial-ethnic differences in all-cause mortality after stroke in a cohort of veterans living in the southeastern United States. Methods: Data on a cohort of 4115 veterans with a diagnosis of stroke were analyzed. The cohort included veterans who classified themselves as non-Hispanic White, non-Hispanic Black, or Other. All veterans had a diagnosis of ischemic or hemorrhagic stroke. All subjects were seen in Veterans Affairs facilities in the Charleston, South Carolina area and were followed from January 1, 2000 to December 31, 2006. Cox proportional hazards regression models were used to compare survival times by race/ethnicity, adjusting for relevant covariates. Results: In 38 months of follow-up, 1232 veterans in the cohort died. Compared with non-Hispanic White veterans, Black veterans were ≈20% more likely to die, and other ethnicities were ≈20% less likely to die in the unadjusted model. In the adjusted model, the White-Black disparity increased somewhat, and the disparity between Whites and other ethnicities was somewhat attenuated. Age, coronary heart disease, cancer, and Charlson co-morbidity index >2 were also associated with higher mortality. Conclusions: Non-Hispanic Black veterans with a history of stroke in the southeastern United States had significantly higher mortality than did Non-Hispanic White veterans and veterans of other ethnicities, even after adjusting for relevant covariates.