Abstract 309: Interaction of Relative Socioeconomic Disadvantage and Age on Stroke Thrombectomy Clinical Outcomes in the US
PurposeRecent randomized clinical trial data from Brazil indicated that mechanical thrombectomy (MT) was not beneficial in patients ≥70years‐old. Social determinants of health are increasingly recognized as critical in clinical outcomes research; therefore, we evaluated the interaction of age and so...
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| Published in: | Stroke: vascular and interventional neurology Vol. 4; no. S1 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Phoenix
Wiley Subscription Services, Inc
01-11-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | PurposeRecent randomized clinical trial data from Brazil indicated that mechanical thrombectomy (MT) was not beneficial in patients ≥70years‐old. Social determinants of health are increasingly recognized as critical in clinical outcomes research; therefore, we evaluated the interaction of age and socioeconomic status on MT outcomes in the US.MethodsCross‐sectional analysis of consecutive MT cases from a prospective comprehensive‐stroke‐center database spanning 2018‐2024. The 2022 Area Deprivation Index (ADI‐a well validated social exposome tool) was used to quantify neighborhood disadvantage based on the patient's residential address at the time of stroke. ADI ranged from 1[least disadvantaged]‐100[most]. The relationship between ADI and 90‐day modified Rankin Scale (mRS) by age (<70vs.≥70years) was assessed. Secondary analyses included ADI association with discharge mRS, as well as insurance‐related interaction with 90‐day mRS stratified by age.Results1,190 patients were included; median age was 66[54—76], being 61.4% <70years‐old/38.6% ≥70years‐old. In the most disadvantaged ADI quintile, 18.2% are from the younger and 14.8% from the older arm. In the <70 group, median ADI was 21[14—30], with a 0.09(95% CI:0.01—0.17) Pearson correlation for the 90‐day mRS‐very weak/non‐significant positive correlation. For the ≥70 group, median ADI was 77.5[44.5—89] while the correlation was 0.04(95% CI: ‐0.05—0.13)‐no meaningful correlation(Figure 1). No significant interaction between age and outcomes was found when stratified by insurance type(Figure 2). Secondary analysis using discharge mRS confirmed these findings, with a correlation of 0.05(95% CI: ‐0.04—0.13) for both groups.ConclusionWe found no significant impact of neighborhood disadvantage on stroke outcomes in elderly patients undergoing MT. MT effectiveness appears not to be reduced in lower socio‐economic status patients in the US as observed in Brazil. |
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| ISSN: | 2694-5746 2694-5746 |
| DOI: | 10.1161/SVIN.04.suppl_1.309 |