Stroke Outcomes Among English- and Spanish-Speaking Mexican American Patients

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.