脳卒中における格差：機械的血栓回収後の長期機能予後と社会経済的地位の関連

Socioeconomic status is regarded as a significant predictor of poor outcomes after ischemic stroke. However, there is sparse evidence of its effect in patients undergoing mechanical thrombectomy. This study aimed to explore the effect of socioeconomic status on long-term functional outcomes after mechanical thrombectomy.

A retrospective, self-adjudicated, single-center study comparing favorable and unfavorable functional outcomes through risk factors, demographic factors, and neighborhood socioeconomic status was performed. Functional outcome was defined by modified Rankin scale scores evaluated at 90 days after thrombectomy.

Factors that were independently associated with favorable functional outcome included age (odds ratio [OR], 0.97; 95% CI, 0.96-0.98 [P<0.001]), baseline National Institutes of Health Stroke Scale scores (OR, 0.94; 95% CI, 0.92-0.97 [P<0.001]), baseline modified Rankin scale scores (OR, 3.02; 95%CI, 1.46-6.25 [P=0.003]), ischemic core size at presentation (OR, 0.47; 95% CI, 0.26-0.84 [P=0.011]), symptomatic intracranial hemorrhage (OR, 0.3; 95% CI, 0.14-0.66 [P=0.003]), puncture-to-recanalization time (OR, 0.99; 95% CI, 0.98-1.00 [P=0.007]), median income based on zip code (OR, 1.01; 95% CI, 1.00-1.02 [P=0.016]), and final modified thrombolysis in cerebral infarction (OR, 6.05; 95% CI, 2.23-16.08 [P<0.001]).

Patients from zip codes with higher median income who achieved successful reperfusion during mechanical thrombectomy were more likely to achieve a long-term favorable functional outcome.