Disparities in Stroke: Associating Socioeconomic Status With Long‐Term Functional Outcome After Mechanical Thrombectomy

Abstract

Background 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. Methods 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. Results 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]). Conclusions 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.

Keywords

• disparities
• functional outcomes
• socioeconomic
• stroke
• thrombectomy