• SantosAngela DosAD0000-0003-4301-9396Melbourne Brain Centre at Royal Melbourne Hospital, Parkville, VIC, Australia.The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia., Katherine Mohr, Martin Jude, Neil G Simon, Mark Parsons, Sandra Eades, Luke Burchill, Stephen Davis, Geoffrey Donnan, Leonid Churliov, and Candice Delcourt.
• Melbourne Brain Centre at Royal Melbourne Hospital, Parkville, VIC, Australia.
• Intern Med J. 2022 Mar 1; 52 (3): 468473468-473.

BackgroundCardiovascular disease is the most common cause of death and disability in indigenous communities but limited prospective data exist about stroke.AimsTo estimate the difference in stroke recognition, risk factors, treatment rates and outcomes between indigenous and non-indigenous peoples admitted to the Wagga Wagga Rural Referral Hospital (WWRRH) over a 5-year period with a suspected acute stroke.MethodsAll suspected strokes presenting to the 33 peripheral hospitals within the Murrumbidgee Local Health District (MLHD) were transferred to the WWRRH and prospectively assessed over a 5-year period from 1 January 2012 to 31 December 2017. Actions at stroke onset, risks factors, stroke type, treatment and outcomes were analysed.ResultsA total of 1843 patients were included. Of these, 45 (2.5%) patients were indigenous. Only 26.6% of indigenous and 34% of non-indigenous patients knew of the face, arm, speech, time (FAST) acronym. Indigenous patients were younger (mean age 62.0 years vs 74.4 years) and more likely to have diabetes (risk difference (RD) 22.3% (95% CI: 3%, 41.7%)), dyslipidaemia (RD 19.4% (95% CI: 21.%, 36.7%)), and be ever smokers (RD 24.9% (95% CI: 9.5%, 40.3%)). Stroke types were similar except lacunar infarcts were more common (19.2% vs 8.4%). Treatment rates and outcomes were similar between the two groups.ConclusionsIndigenous Australians with stroke are a decade younger and have a higher prevalence of important, modifiable stroke-risk factors. Delayed presentation to hospital is more common, due in part to stroke symptoms being underrecognised. When admitted to a specialised stroke unit, treatment rates and outcomes are comparable.© 2020 Royal Australasian College of Physicians.

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