Socioeconomic influences on stroke outcomes: A comprehensive zip code-based hospital analysis

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• Stroke is a major cause of death and disability globally.
• Socioeconomic disparities influence cardiovascular and cerebrovascular disease treatment and outcomes.
• Acute ischemic stroke care is particularly affected by socioeconomic factors.

Purpose of the Study:

• To investigate the relationship between socioeconomic status (SES) and outcomes in patients undergoing mechanical thrombectomy for acute ischemic stroke.
• To analyze treatment times and functional outcomes based on income quintiles.
• To identify predictors of good functional outcomes in a diverse patient population.

Main Methods:

• Retrospective analysis of 697 patients who underwent mechanical thrombectomy (2016-2023).
• Socioeconomic status determined by matching patient ZIP codes to median household income data.
• Patients stratified into five income quintiles (Q1-Q5) for analysis.
• Multivariate regression used to identify predictors of good functional outcomes (modified Rankin Scale 0-2).

Main Results:

• No significant differences in stroke outcomes (recanalization, hemorrhagic transformation, discharge status, length of stay) between low (Q1) and high (Q5) SES groups.
• Higher SES patients had significantly shorter onset-to-arterial puncture times (258 min vs. 369 min).
• Socioeconomic status was not a significant predictor of good functional outcomes.

Conclusions:

• Mechanical thrombectomy for acute ischemic stroke yields similar outcomes regardless of socioeconomic status.
• Socioeconomic status influences pre-hospital or in-hospital delays but not ultimate functional recovery.
• Further research is warranted to explore disparities in stroke care and outcomes.