Correlation Of Socioeconomic Status And Short-term Functional Outcome After Stroke

Background and Objective:Stroke is a major disease affecting human health,with the characteristics of high incidence,disability and mortality.Stroke brought heavy burden to family and the society.Studies have shown that socioeconomic status(SES)is closely related to the development of stroke,and people from lower socioeconomic groups have a higher burden of stroke in terms of both incidence and case fatality rates.Previous studies also reported a social gradient in impairment after stroke with patients from lower socioeconomic groups having poorer functional outcome than patients from higher socioeconomic groups.However,there is diversity between different SES indicators and the functional outcomes of stroke,and the social gap in stroke outcome is also not yet fully understood in China.The purpose of this study is to investigate the correlation of socioeconomic status and short-term functional outcome after stroke in Nanjing and surrounding areas.Methods:We designed a single center prospective cohort study and recruited first ever stroke patients From October 2013 to March 2015.SES were assessed by education level,occupation,economic income,residence,marital status,housing space,traffic and medical insurance status.Basic information were collected including social economic information,stroke severity and risk factors.The next morning to take venous blood for testing.The short-term functional outcome were assessed by the 3-month mRS through telephone or outpatient follow-up.The stroke severity was evaluated by the admission NIHSS.Good outcome was defined as mRS≤2.Spearman correlation analysis was undertaken to evaluate the association between different measures of SES.Univariable analysis and multivariable logistical analysis were used to evaluate the related factors influencing the short outcomes of stroke.Results:This study participants included 1252 patients with first-ever stroke,125 patients were lost to follow-up,a total of 1127 cases were included in data analysis.Of which,1012(89.8%)cases were ischemic stroke and 115(10.2%)cases were hemorrhagic stroke,369(32.7%)were women,average age was 60(51-68),818(72,6%)patients had good functional outcome.In univariant analysis,marital status,health insurance status,residence,occupation and income was associated with the short-term functional outcome after stroke.Lower age,lower severity of stroke and the type of ischemic stroke were predictors of good functional outcome.Adjusted for baseline NIHSS,age and stroke subtype,unmarried(OR=1.685,95%CI:1.017-2.790)was associated with less chance for favorable outcomes.Urban residents have an increased trend in advanced outcome than rural residents(OR=1.508,95%CI:0.962-2.363),manual workers was associated with less chance for favorable outcomes than unmanual workers(OR=1.711,95%CI:0.953-3.073).With medical insurance(OR=1.607,95%CI:1.007-2.565),with higher income(OR=1.827,95%CI:1.102-3.029)were associated with lower mRS scores.Conclusion:Patients with higher SES have considerably higher rates of good functional outcome after stroke,timely and effective treatment strategies targeting people in low socioeconomic groups are required along with rehabilitation therapy to promote the prognosis of stroke patients.