Socioeconomic status and transient ischaemic attack/stroke: a prospective observational study

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Lower socioeconomic status (SES) is linked to increased stroke risk, but underlying mechanisms require elucidation.
• Investigating the association between SES, vascular risk factors, comorbidities, and healthcare access in stroke/transient ischaemic attack (TIA) patients is crucial.

Purpose of the Study:

• To determine if stroke/TIA patients with lower SES exhibit a higher burden of vascular risk factors and comorbidities.
• To assess if lower SES impacts healthcare access, including investigations and stroke unit care.

Main Methods:

• A prospective study of 467 consecutive stroke and TIA patients from three Scottish hospitals.
• Vascular risk factors, stroke severity, comorbidities, investigations, and healthcare utilization were recorded.
• Socioeconomic status (SES) was determined by postcode using Scottish Neighbourhood Statistics and analyzed in quartiles.

Main Results:

• Patients in the lowest SES quartile were younger and more likely to be current smokers compared to the highest quartile.
• A trend indicated more severe strokes in lower SES patients, though this was not significant after multivariate analysis.
• Lower SES groups showed reduced rates of neuro-imaging and electrocardiogram use, but access to stroke unit care was equitable.

Conclusions:

• Younger stroke/TIA patients with lower SES present with more severe deficits, with smoking identified as a significant contributing factor.
• Despite disparities in certain investigations, access to specialized stroke unit care was consistent across socioeconomic strata.