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Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke
Published on: February 22, 2020
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Neighborhood Deprivation and Functional Outcomes Following Ischemic Stroke (P2-4.007).
Leah Kleinberg1, Santiago Clocchiatti-Tuozzo1, Cyprien Rivier1
1Yale University, Department of Neurology.
Neurology
|February 20, 2025
Summary
Neighborhood deprivation increases the risk of poor outcomes after acute ischemic stroke (AIS). Higher deprivation levels correlate with worse long-term functional recovery, highlighting social determinants of health in stroke care.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Neighborhood deprivation is linked to increased stroke risks and mortality.
- Long-term functional outcomes after acute brain injury are understudied concerning neighborhood deprivation.
Purpose of the Study:
- To investigate the hypothesis that neighborhood deprivation negatively impacts long-term functional outcomes in acute ischemic stroke (AIS) survivors.
- To assess the association between neighborhood deprivation and functional recovery one year post-stroke.
Main Methods:
- A nested study within a prospective longitudinal cohort of AIS patients.
- Neighborhood deprivation measured using the Area Deprivation Index (ADI) based on 9-digit zip codes.
- Functional outcomes assessed using the modified Rankin Scale at one year, analyzed via multivariable logistic regression.
Main Results:
- Increased risk of unfavorable outcomes observed with higher neighborhood deprivation levels.
- Patients in high deprivation areas had a 97% greater risk of unfavorable outcomes compared to those in low deprivation areas (OR 1.98).
- The association remained significant after controlling for comorbidities and stroke severity (p<0.001).
Conclusions:
- Neighborhood deprivation is a significant predictor of poor long-term functional outcomes after AIS.
- The Area Deprivation Index (ADI) effectively quantifies neighborhood deprivation as a composite of social determinants of health.
- Findings emphasize the need to address socioeconomic factors in stroke recovery and care.
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