Mitigating Disparities in Stroke Rehabilitation Care: Sana Somani, MD, MBBS

“We as neurologists, and even primary care physicians, need to be more active and work on primary prevention of strokes in [women]. We have to be more aggressive in treating their Atrial fibrillation (AFib), their hypertension, their diabetes, their cholesterol levels, all the factors that are potential risk factors for stroke, both ischemic and hemorrhagic.”

Women and African American patients have lower functional performance during acute inpatient rehabilitation than men and Caucasian patients after intracerebral hemorrhagic (ICH) strokes, according to a recent study presented at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22 by Sana Somani, MD, MBBS, vascular neurology fellow, University of Maryland Medical Center.

Somani and colleagues retrospectively analyzed a cohort of 65 ICH patients admitted to the University of Alabama at Birmingham from December 2016 through December 2019. They found that being male was positively associated with Functional Independence Measure (FIM) efficiency (β=1.02; P = .0063) after adjusting for race and ICH score, while FIM efficiency was lower in African American patients (β=-0.95; P = .0092) after adjusting for gender and ICH volume. No significant differences in ICH volumes and scores were seen with respect to discharge FIM scores.

NeurologyLive spoke with Somani to learn more about strategies that may be able to mitigate lower efficacy of rehabilitation in the 2 most affected groups: women and African American patients, and in particular, African American women. She also spoke to how comorbidities found in these populations should be taken into account and proactively treated.

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REFERENCE

Somani S, Nanavati H, Xiaohua Z, Lin C. African American women have lower functional performance during acute inpatient rehabilitation after intracerebral hemorrhagic strokes. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22. Abstract P5 073