What This Means
This research examined whether being an immigrant affects the type and intensity of hospital care received after a stroke in Ontario, Canada. Using data from over 85,000 stroke patients treated between 2014 and 2023, the study found that immigrants were just as likely as long-term Canadian residents to be admitted to the intensive care unit (ICU) following a stroke. However, once admitted, immigrants stayed in the ICU significantly longer — on average 5.6 days compared to 3.8 days for long-term residents, even after accounting for differences in age, stroke severity, and other factors.
Interestingly, immigrants were younger and had less severe strokes on average, yet they received more life-sustaining interventions such as mechanical ventilation and feeding tubes. This pattern of longer ICU stays persisted even among patients who did not receive clot-busting or clot-removal treatments, and it was not explained by whether a hospital served many immigrants or few. Certain groups — including refugees and immigrants from Africa, East Asia, and the Middle East — had especially long ICU stays compared to long-term residents.
This research suggests that immigrant stroke patients experience a distinct pattern of acute hospital care that does not simply reflect differences in stroke severity or access to advanced treatments. The reasons for longer ICU stays are not fully understood — they may relate to differences in goals-of-care conversations, language barriers, cultural factors, or end-of-life decision-making. The study highlights an important gap: it is not yet known whether the longer ICU stays translate into better, worse, or similar long-term functional recovery for immigrant patients, which is a critical question for future research.