Are there socio-economic inequities in access to reperfusion therapy: The stroke 69 cohort - EHESP - École des hautes études en santé publique Access content directly
Journal Articles Revue Neurologique Year : 2021

Are there socio-economic inequities in access to reperfusion therapy: The stroke 69 cohort

Abstract

Background and purpose: Low socio-economic status of individuals has been reported to be associated with a higher incidence of stroke and influence the diagnosis after revascularization. However, whether it is associated with poorer acute stroke management is less clear. To determine whether social deprivation was associated with a poorer access to reperfusion therapy, either intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT) in a population-based cohort.Methods: Over a 14-month period, all consecutive adult patients admitted to any emergency department or a comprehensive or primary stroke center (CSC/PSC) of the Rhône county with a confirmed ischemic stroke were included. The socioeconomic status of each patient was measured using the European Deprivation Index (EDI). The association between EDI and access to reperfusion therapy was assessed in univariate and multivariate logistic regression analyses.Results: Among the 1226 consecutive IS patients, 316 (25%) were admitted directly in a PSC or CSC, 241 (19.7%) received a reperfusion therapy; 155 IVT alone, 20 EVT alone, and 66 both therapies. Median age was 79 years, 1030 patients had an EDI level of 1 to 4, and 196 an EDI of 5 (the most deprived group). The most deprived patients (EDI level 5) did not have a poorer access to reperfusion therapy compared to all other patients in univariate (OR 1.22, 95%CI [0.85; 1.77]) nor in multivariate analyses (adjOR 0.97, 95%CI [0.57; 1.66]).Conclusions: We did not find any significant association between socioeconomic deprivation and access to reperfusion therapy. This suggests that the implementation of EVT was not associated with increased access inequities.
Fichier principal
Vignette du fichier
S0035378721005919.pdf (343.37 Ko) Télécharger le fichier
Origin Files produced by the author(s)

Dates and versions

hal-03312744 , version 1 (05-01-2024)

Licence

Identifiers

Cite

A. Perrin, J. Freyssenge, J. Haesebaert, K. Tazarourte, A. Termoz, et al.. Are there socio-economic inequities in access to reperfusion therapy: The stroke 69 cohort. Revue Neurologique, 2021, 177 (9), pp.1168-1175. ⟨10.1016/j.neurol.2021.02.394⟩. ⟨hal-03312744⟩
68 View
2 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More