社会经济地位对中风后功能结果的影响:系统性审查和元分析
Mai T H Nguyen1,2, Yuki Sakamoto1,3, Toshiki Maeda1,4
1The George Institute for Global Health, The University of New South Wales Sydney New South Wales Australia.
Journal of the American Heart Association
|April 19, 2024
概括
社会劣势显著影响中风恢复,低教育,收入和弱势社区与较差的功能结果有关. 这些社会经济因素仍然是关键的风险因素,尽管中风护理的进步.
科学领域:
- 神经科学和神经病学 神经科学和神经病学
- 公共卫生和流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 脑卒中显著影响患者的功能结果.
- 社会经济地位 (SES) 越来越被认为是健康的决定因素.
- SES对中风后功能恢复的特定影响需要详细量化.
研究的目的:
- 量化社会经济地位对中风后功能结果的影响.
- 确定与功能结果最强烈相关的特定社会经济地位指标.
主要方法:
- 通过Medline和Embase的系统文献搜索 (开始至2022年5月).
- 纳入19个观察性研究 (n≥100) 具有低偏差风险,通过经过修改的纽卡斯尔太华尺度进行评估.
- 随机效应元分析,汇集功能结果 (修改的兰金表,巴特尔指数) 和SES指标 (教育,收入,职业,保险,社区贫困) 的数据.
主要成果:
- 低社会经济地位与中风后的功能表现差显著相关.
- 关键指标包括较低的教育程度 (OR 1.66),较低的收入 (OR 1.36),手工/失业职业 (OR 1.62) 和社区贫困 (OR 1.55).
- 低健康保险状况显示出对较差结果的非显著趋势 (OR 1.32).
结论:
- 社会劣势是急性中风后功能表现不佳的持续风险因素.
- 尽管治疗方面取得了进展,但与社会经济因素相关的差异仍然存在.
- 进一步的研究对于阐明因果机制和解决这些差异至关重要.
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