Socioeconomic status and transient ischaemic attack / stroke: a prospective observational study

Kerr, G.D., Higgins, P., Walters, M. , Ghosh, S.K., Wright, F., Langhorne, P. and Stott, D.J. (2011) Socioeconomic status and transient ischaemic attack / stroke: a prospective observational study. Cerebrovascular Diseases, 31(2), pp. 130-137. (doi: 10.1159/000321732)

Abstract

<p>Background: Lower socioeconomic status (SES) is associated with an increased risk of stroke but the mechanisms are unclear. We aimed to determine whether low-SES stroke/transient ischaemic attack (TIA) patients have a greater burden of vascular risk factors/co-morbidity and reduced health care access.</p> <p>Methods: We prospectively studied 467 consecutive stroke and TIA patients from 3 Scottish hospitals (outpatients and inpatients) during 2007/2008. We recorded vascular risk factors, stroke severity, co-morbidity measures, investigations and health service utilisation. SES was derived from postcodes using Scottish Neighbourhood Statistics and analysed in quartiles.</p> <p>Results: TIA/stroke patients in the lowest SES quartile were younger (64 years, SD 14.1) than those in the highest quartile (72 years, SD 12.9; p < 0.0001). They were more likely to be current smokers (42 vs. 22%; p = 0.001) but there was no association with other vascular risk factors/co-morbidity. There was a trend for those with lower SES to have a more severe stroke [modified National Institutes of Health Stroke Scale score and interquartile range: 4 (2–6) vs. 3 (1–5); multivariate p = 0.05]. Lower SES groups were less likely to have neuro-imaging (82 vs. 90%; p = 0.036) or an electrocardiogram (72 vs. 87%; p = 0.003), but differences were no longer significant on multivariate analysis. However, there was equal access to stroke unit care.</p> <p>Conclusions: Low-SES TIA and stroke patients are younger and have a more severe deficit; an increased prevalence of smoking is likely to be a major contributor. We found equal access to stroke unit care for low-SES patients.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Walters, Professor Matthew and Langhorne, Professor Peter and Kerr, Dr Gillian and Stott J, Professor David and Higgins, Dr Peter
• Authors: Kerr, G.D., Higgins, P., Walters, M., Ghosh, S.K., Wright, F., Langhorne, P., and Stott, D.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Cerebrovascular Diseases
• ISSN: 1015-9770