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NCT06955442Active, not recruiting

Racial Disparities in Acute Stroke

Analysis of Ethnic and Racial Disparities in Access to Acute Stroke Care in Italy: A Multicentric, Prospective Cohort Study

Source: ClinicalTrials.gov · Last updated 2 May 2025

Brief summary (registry, in English)

Ischemic stroke is one of the leading causes of mortality and disability worldwide. Although the prevalence of stroke is high globally, not all ethnic and racial groups are affected in the same way, leading to the classification of stroke as an inequitable disease. First of all, ethnic and racial background influences the pathogenesis of stroke, as numerous risk factors-both modifiable and non-modifiable-are more prevalent in Black and Hispanic populations compared to Asian ones. As a direct consequence, the incidence of stroke is higher in Black and Hispanic individuals than in White individuals. Unfortunately, despite this, access to revascularization treatments is not always guaranteed for ethnic and racial minorities, although in recent years, this inequality in access to care appears to be decreasing. Moreover, stroke prognosis also seems to differ based on race/ethnicity, with mortality being higher among Black individuals compared to White individuals, although this trend tends to decrease with advancing age. On the other hand, although cerebral hemorrhage is more prevalent in Black and Asian populations than in White populations, it tends to have a better prognosis in these minority groups. It must be considered, however, that the vast majority of studies on this topic have been conducted in the United States, where the ethnic and racial composition of the population is very different from that of Italy and Europe. In these latter contexts, studies investigating the impact of race and/or ethnicity on the clinical characteristics, management, and prognosis of ischemic stroke are lacking. Furthermore, differences in healthcare system organization may play a significant role in limiting access to timely and appropriate medical care for acute stroke based on race and/or ethnicity. Italy is a country where, similarly to other European nations, the last few decades have seen a significant increase in immigration rates, particularly from Eastern Europe. Today, foreigners account for approximately 9% of the total population. Nevertheless, in Italy, systemic racism toward ethnic and racial minorities remains a significant issue, as evidenced by large disparities in educational attainment, socioeconomic status, and housing conditions between Italian citizens and foreign residents. Although the universal national healthcare system in Italy should ensure equal access to care and emergency treatment for all, regardless of ethnic and racial background, there are no studies investigating this topic. A recent scoping review highlighted how individual racism plays a primary role in generating health inequalities, whereas there is very limited evidence focused on the analysis of structural and institutional racism in the Italian and European context. As a consequence, this study aims to prospectively investigate the presence and the extent of racial and ethnic disparities in access to stroke care and treatment across several Italian comprehensive stroke centers.

Status (registry)
Active, not recruiting
Study type
Observational
Enrollment
4500 (estimated)
First submitted
16 Apr 2025
Start date
3 Apr 2025
Primary completion date
15 Oct 2026
Lead sponsor
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Diseases
Stroke
NCT number
NCT06955442

What you commit to

  • Study type: Observational
  • Planned participants: 4500
  • From 3 Apr 2025 to the primary completion date, 15 Oct 2026
  • 15 sites in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Other illness

  • Discharge diagnosis other than ischemic stroke;

Other

  • Refusal to participate in the study.

Who the study is looking for

  • Adults (≥18 years old);
  • Admission to the Emergency Department of the participating center with a diagnosis of ischemic stroke, as defined by the International Classification of Diseases, 9th Revision (ICD-9) codes;
  • Signed informed consent provided by the patient or, in cases of impaired decision-making capacity, by their legal guardian/representative.

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (15)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
UOS Neurologia-AOU, IRCCS Istituto delle scienze Neurologiche
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BolognaItalyUnknown status
Ospedale Maggiore, IRCCS Istituto delle Scienze Neurologiche di Bologna - UO Neurologia OM e Rete Stroke Metropolitana (SC)
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BolognaItalyUnknown status
UOC Neurologia, ASST Crema
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CremaItalyUnknown status
UOC Neurologia - Ospedale Spaziani
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FrosinoneItalyUnknown status
IRCCS Ospedale Policlinico San Martino
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GenovaItalyUnknown status
Ospedale Vito Fazzi
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LecceItalyUnknown status
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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NaplesItalyUnknown status
Fondazione IRCCS Policlinico San Matteo
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PaviaItalyUnknown status
IRCCS Fondazione Istituto Neurologico C. Mondino
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PaviaItalyUnknown status
IRCCS Istituto Neurologico Mediterraneo Neuromed
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PozzilliItalyUnknown status
Policlinico Tor Vergata
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RomaItalyUnknown status
Fondazione Policlinico Universitario A. Gemelli IRCCS
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RomeItalyUnknown status
Policlinico Umberto I
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RomeItalyUnknown status
Humanitas Research Hospital IRCCS
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RozzanoItalyUnknown status
UOC Neurologia Belcolle - Ospedale Belcolle
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ViterboItalyUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.