EMBARGOED FOR RELEASE UNTIL 4 PM ET, September 02, 2026
In Canada, immigration status is associated with length of ICU stay after stroke
Highlights:
- Among people who have a stroke in Canada, immigrants were admitted to the ICU at similar rates as long-term residents or people born in Canada.
- Immigrants were more likely to have longer stays in the ICU than long-term residents.
- Immigrants were younger, had milder strokes and were less likely to receive treatments to restore blood flow.
- Immigrants were more likely to receive life-sustaining treatments like ventilators or feeding tubes.
- The difference in use of life-sustaining treatments was small and should be interpreted with caution, researchers say.
MINNEAPOLIS — Among people who have a stroke in
Canada, immigrants were admitted to the intensive care unit (ICU) at similar
rates as long-term residents or people who were born in Canada, but they were
more likely to have longer stays in the ICU, according
to a study published September 2, 2026, in Neurology®, the medical journal of the American Academy of Neurology.
People were defined as immigrants if they were born outside
Canada and arrived in the country after 1985. They were compared to people born
in Canada or who immigrated before 1985, called long-term residents.
“Immigration status is recognized as a key social
determinant of health, and with the number of immigrants increasing around the
world in recent decades due to war, persecution and climate change, we wanted
to take a closer look at how immigration status may be associated with stroke
care,” said study author Manav V. Vyas, MBBS, PhD, of St. Michael’s
Hospital-Unity Health Toronto and the University of Toronto and a member of the
American Academy of Neurology.
For the study, researchers looked at records for all people
hospitalized with an ischemic stroke in Ontario, Canada, from 2014 to 2023.
Ischemic stroke is the most common kind of stroke. It is caused when blood flow
is blocked to part of the brain.
The study examined who received treatments to restore blood
flow, either through clot-busting drugs or clot removal procedures. It also
looked at who was admitted to the ICU, how long they stayed in the ICU and who
received breathing support and feeding tubes.
Of the 85,507 people in the study, 12.9% were immigrants. Immigrants
were younger, with an average age of 69 compared to 76 for the long-term
residents. The immigrants had less severe strokes on average.
Regarding stroke care treatments, immigrants were less
likely to receive treatments to restore blood flow than long-term residents, at
17.2% compared to 18.0%. They had slightly higher rates of life-sustaining
treatments, including breathing support through a ventilator, at 6.5% versus
5.3%, and feeding tube placement, at 3.0% versus 1.9%.
There was no difference in how often immigrants and
long-term residents were admitted to the ICU. But of those who were in the ICU,
immigrants had longer stays, an average of 5.6 days compared to 3.8 days for
long-term residents. After adjusting for other factors that could affect length
of stay, such as age, stroke severity and other health conditions, researchers
found that immigrants were 30% more likely to have a longer stay in the ICU.
The researchers didn’t find any differences in stroke care
between hospitals that cared for a higher-than-average proportion of immigrants
and those hospitals that cared for a lower-than-average proportion.
“Possible reasons for the longer stays in the ICU could be
language barriers and differences in attitudes toward end-of-life care among
various cultural and religious practices,” Vyas said. “Fewer immigrants had
palliative care consultations, or specialized care focused on comfort and
quality of life, than long-term residents, which could help explain the longer
ICU stays. Improving access to interpreter services and creating educational
opportunities for staff to understand cultural practices could help reduce
these differences in length of ICU stays.”
Vyas noted that the differences in life-sustaining
treatments were small and were not adjusted for factors such as patient age, so
this information should be interpreted with caution. Another limitation of the
study was that some information on treatments to restore blood flow, such as
timing and complications, was not available.
The study was supported by IC/ES
in Ontario, the PSI Foundation and the Heart and Stroke Foundation of Canada.
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