Health disparities in moyamoya
Irshad K, Malik S, Zahoor S, and Schultz L. Health disparities in moyamoya. Cerebrovasc Dis 2018; 45(Suppl 1):438.
OBJECTIVE: To describe characteristics of patients presenting with moyamoya syndrome (MMS) to a tertiary center in an ethnically diverse urban cohort. METHODS: Retrospective analysis of patients presenting to our institution from 1995 to 2016 was performed. ICD9 and 10 codes for moyamoya disease and MMS were confirmed through chart review. We reviewed 252 patients, 181 were excluded due to diagnosis of aneurysm, stroke, or other conditions. Chart review was conducted on 71 patients with angiographically confirmed MMS. SAS version 9.4 was used. The AA and Caucasian patients were reviewed using chi-squared tests for the categorical variables and two-sample test for age. Results: 71 cases were confirmed to have MMS. Of these, 28 were AA, 30 Caucasian, 1 Asian, 11 had race coded as unknown and 1 missing race. Most were female, (68% AA and 73% Caucasians). Mean age of onset was about the same for both races, 34.1 and 35.6 years with most patients (26%) in the age group 30-39. The most common symptom was unilateral weakness (23%). AA's had a significantly lower rate of transient ischemic attacks (TIA) compared to Caucasian patients (7% vs 27%, p=0.049). AA patients were also noted to have higher rates of weakness (32% vs 13%, p=0.086). Most common risk factor was hypertension which was higher in AA (56% vs 38%). Hyperlipidemia (41% vs 31%) was also higher in AA. Smoking (52% vs 44%), diabetes (24% vs 15%) and CAD (10% vs 7%) were higher in Caucasians. Treatments were medical management only (41%) and surgical intervention (31%). AA's had significantly higher rates of receiving medical treatment compared to Caucasians (86% vs 60%, p=0.029). They had a slightly lower rate of receiving surgical treatment, but this difference was not significant (32% vs 43%, p=0.38).