Association between socioeconomic status and prognosis after ischemic stroke in South China

Background: Previous studies have conflicting results on the association between socioeconomic status and stroke outcomes. Thus, this study aimed to investigate whether socioeconomic status is associated with the prognosis of ischemic stroke in Guangzhou, South China. Methods: A total of 622 patients with ischemic stroke who were admitted in the neurology department of five general hospitals in Guangzhou from May 2014 to October 2014 were included in the study. Socioeconomic status was measured based on education, income, caregiver, and insurance. The modified Rankin scale was used to evaluate the two years prognosis of patients with stroke. A multivariate logistic regression model was performed to determine the association between socioeconomic status and ischemic stroke prognosis. Results: In 2 years follow-up, 542 ischemic stroke patients were interviewed by telephone. Age ranged from 31 to 96 years, 65.5% of the patients were male. 33.9% of patients with ischemic stroke had a poor prognosis. After adjustment for age, sex, cardiovascular disease, behavior lifestyle, and severity of stroke, odds ratio for poor prognosis in patients with low income was 1.84 (95%CI 1.05-3.22), family caregiver 3.19 (95%CI 1.05-9.70), and no insurance 1.68 (95%CI 1.02-2.77). Conclusions: Patients with low income, family caregiver, and no insurance have a poorer prognosis after ischemic stroke that can be partly explained by intermediate variable in the patients' demographic characteristics, cardiovascular disease, behavior lifestyle, and stroke severity. Abbreviations: DALYs: disability-adjusted life years; SES: socioeconomic status; FMC: free medical care; MIUR: medical insurance for urban residents; MIUE: medical insurance for urban employees; NCMS: new rural cooperative medical scheme ; NIHSS: National Institute of Health Stroke Scale ; mRS: modified Rankin scale; OR: odds ratios; CI: confidence interval.