Abstract WP135: Ischemic Stroke Outcomes in the Deaf Signing Population

Introduction: An estimated 500,000 culturally Deaf signers in the U.S. face healthcare disparities, however, research on ischemic stroke outcomes in this population is lacking. Prior studies document critical gaps in stroke symptom recognition and higher rates of stroke risk factors in Deaf individuals. Similar disparities, including treatment delays and reduced rates of acute therapies, have been documented in other minority populations, such as the Hmong community, an underrepresented group within our hospital system. This study aims to determine if Deaf patients have worse stroke outcomes than their English-speaking peers and to investigate if their disparity patterns align with those of other minority groups. Methods: We compared outcomes of Deaf American Sign Language (ASL) users (n=21) with matched English (n=210), and Hmong (n=21) speakers between 2/2015 to 2/2025. Cases were matched by stroke type (acute ischemic stroke [AIS] or transient ischemic attack [TIA]), age, and gender. Data was manually extracted from electronic medical records. Statistical analysis used Pearson’s Chi-squared and Fisher’s exact tests (for categorical outcomes) or Kruskal-Wallis rank sum test (for the continuous outcome) in order to evaluate for significant differences in the outcomes among the three groups. Results: Patients in the ASL group had significantly higher baseline comorbidity rates based on their documented medical history at the time of hospitalization. The median time from emergency room arrival to brain imaging was 119.50 minutes (49.00–924.00) for the ASL group, which was significantly longer (p=0.008) than for the Hmong (35.00 mins; 14.00–78.00) and English-speaking groups (81.00 mins; 24.00–183.00). The Hmong group exhibited higher baseline glucose levels (p=0.005) and higher emergency room systolic blood pressure (p=0.004). No significant differences were observed in stroke etiology, discharge modified Rankin Scale scores, baseline NIH Stroke Scale scores, time from last known well to ER arrival, or the proportion of stroke code activations. Conclusion: This study reveals that Deaf ASL users with ischemic stroke experience higher rates of comorbid conditions and delays in diagnostic imaging compared to English and Hmong speaking patients. Our study was limited by small sample size and retrospective nature. Further research and targeted interventions to address inequities in stroke care for the Deaf community are needed.