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dc.contributor.authorSong, Tian
dc.contributor.authorPan, Yuesong
dc.contributor.authorChen, Ruoling
dc.contributor.authorLi, Hao
dc.contributor.authorZhao, Xingquan
dc.contributor.authorLiu, Liping
dc.contributor.authorWang, Chunxue
dc.contributor.authorWang, Yilong
dc.contributor.authorWang, Yongjun
dc.date.accessioned2017-08-29T08:30:54Z
dc.date.available2017-08-29T08:30:54Z
dc.date.issued2017-07-26
dc.identifier.citationSong T, Pan Y, Chen R, Li H, Zhao X, Liu L, et al. (2017) Is there a correlation between socioeconomic disparity and functional outcome after acute ischemic stroke? PLoS ONE 12(7): e0181196. https://doi.org/10.1371/journal.pone.0181196
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0181196
dc.identifier.urihttp://hdl.handle.net/2436/620619
dc.description.abstractBackground To investigate the impact of low socioeconomic status (SES), indicated by low level of education, occupation and income, on 3 months functional outcome after ischemic stroke. Methods We analyzed data from the China National Stroke Registry (CNSR), a multicenter and prospective registry of consecutive patients with acute cerebrovascular events occurred between September 2007 and August 2008. 11226 patients with ischemic stroke had SES and clinical characteristics data collected at baseline and mRS measured as indicator of functional outcome in 3 months follow up. Multinomial and ordinal logistic regression models were performed to examine associations between SES and the functional outcome. Results At 3 months after stroke, 5.3% of total patients had mRS scored at 5, 11.3% at score 4, 11.1% at score 3, 14.4% at score 2, 34.2% at score 1 and 23.7% at score 0. Compared to patients with educational level of ≥ 6 years and non-manual laboring, those < 6 years and manual laboring tended to have higher mRS score (P<0.001). Multinomial adjusted odds ratios (ORs) of outcome in manual workers were significantly increased (ORs from1.38 to 1.87), but OR in patients with less income was not significant. There were similar patterns of association The impact may be stronger in patients aged <65 years (P = 0.003, P<0.001 respectively) and being male (P = 0.001, P<0.001 respectively). Conclusions Our study provides evidence that people who are relatively more deprived in socioeconomic status suffer poorer outcome after ischemic stroke. The influence of low educational level and manual laboring can be more intensive than low income level on 3-month outcome. Health policy and service should target the deprived populations to reduce the public health burden in the society.
dc.description.sponsorshipThis study is supported by grants from the Ministry of Science and Technology of the People’s Republic of China (2006BAI01A11, 2011BAI08B01, 2011BAI08B02, 2012ZX09303-005-001, and 2013BAI09B03), a grant from the Beijing Biobank of Cerebral Vascular Disease (D131100005313003) and a grant from Beijing Institute for Brain Disorders (BIBD-PXM2013_014226_07_000084)
dc.language.isoen
dc.publisherPLoS One
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0181196
dc.subjectacute ischemic stroke
dc.subjectsocioeconomic status
dc.subjecteducation
dc.subjectoccupation
dc.subjectincome
dc.subjectfunctional outcome
dc.titleIs there a correlation between socioeconomic disparity and functional outcome after acute ischemic stroke?
dc.typeJournal article
dc.identifier.journalPLOS ONE
dc.date.accepted2017-07
rioxxterms.funderUniversity of Wolverhampton
rioxxterms.identifier.projectUoW290817RC
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.licenseref.startdate2017-08-29
dc.source.volume12
dc.source.issue7
refterms.dateFCD2018-10-19T09:10:47Z
refterms.versionFCDVoR
refterms.dateFOA2017-08-29T00:00:00Z
html.description.abstractBackground To investigate the impact of low socioeconomic status (SES), indicated by low level of education, occupation and income, on 3 months functional outcome after ischemic stroke. Methods We analyzed data from the China National Stroke Registry (CNSR), a multicenter and prospective registry of consecutive patients with acute cerebrovascular events occurred between September 2007 and August 2008. 11226 patients with ischemic stroke had SES and clinical characteristics data collected at baseline and mRS measured as indicator of functional outcome in 3 months follow up. Multinomial and ordinal logistic regression models were performed to examine associations between SES and the functional outcome. Results At 3 months after stroke, 5.3% of total patients had mRS scored at 5, 11.3% at score 4, 11.1% at score 3, 14.4% at score 2, 34.2% at score 1 and 23.7% at score 0. Compared to patients with educational level of ≥ 6 years and non-manual laboring, those < 6 years and manual laboring tended to have higher mRS score (P<0.001). Multinomial adjusted odds ratios (ORs) of outcome in manual workers were significantly increased (ORs from1.38 to 1.87), but OR in patients with less income was not significant. There were similar patterns of association The impact may be stronger in patients aged <65 years (P = 0.003, P<0.001 respectively) and being male (P = 0.001, P<0.001 respectively). Conclusions Our study provides evidence that people who are relatively more deprived in socioeconomic status suffer poorer outcome after ischemic stroke. The influence of low educational level and manual laboring can be more intensive than low income level on 3-month outcome. Health policy and service should target the deprived populations to reduce the public health burden in the society.


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