ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2022
Rural Stroke Patients Have Higher Mortality: An Improvement Opportunity for Rural Emergency Medical Services Systems.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Pooled it
- Social determinants of health and stroke care and outcomes: SEQUINS lecture 2025.Equity neuroscience · 2026Article
- Surveillance of medical resources for stroke in rural Japan through the Jichi medical university alumni network.Equity neuroscience · 2026Article
- Prospective User Perceptions and Acceptability of a Wearable Fetal Heart Monitor: Cross-Sectional Survey.JMIR formative research · 2026Article
- Review
- Outpatient occupational therapy access for rural stroke survivors: barriers as perceived by therapists.Frontiers in stroke · 2026Article
- Acute treatment of ischemic stroke in 19 Sámi language administrative municipalities in the rural inland of Northern Sweden.Frontiers in stroke · 2026Article
- Intracerebral hemorrhage hospitalizations and outcomes: comparisons between institutional and national data.Internal and emergency medicine · 2025Article
- Patients Residing in Rural Areas Transferred for Mechanical Thrombectomy Undergo Decreased Catheter-Based Treatment.Stroke (Hoboken, N.J.) · 2025Article
- Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study.Prehospital emergency care · 2025Article
- Rurality and Outcomes of Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke.Critical care research and practice · 2025Article
- Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Regional Disparities in Hyperacute Treatment and Functional Outcomes after Acute Ischemic Stroke in Japan.Journal of atherosclerosis and thrombosis · 2024Article
- Stroke and liminality: narratives of reconfiguring identity after stroke and their implications for person-centred stroke care.Frontiers in rehabilitation sciences · 2024Article
- Implementation of an optimised tele-medicine platform for stroke in South Australia improves patient care.Frontiers in neurology · 2024Article
- Rollout of a statewide Australian telestroke network including virtual reality training is associated with improved hyperacute stroke workflow metrics and thrombolysis rate.Frontiers in stroke · 2024Article
- Community socioeconomic and urban-rural differences in emergency medical services times for suspected stroke in North Carolina.The American journal of emergency medicine · 2023Article
- Prehospital Time Interval for Urban and Rural Emergency Medical Services: A Systematic Literature Review.Healthcare (Basel, Switzerland) · 2022Review
- Spatial-temporal analysis of cerebral infarction mortality in Hokkaido, Japan: an ecological study using a conditional autoregressive model.International journal of health geographics · 2022Article
- Time-to-care metrics in patients with interhospital transfer for mechanical thrombectomy in north-east Germany: Primary telestroke centers in rural areas vs. primary stroke centers in a metropolitan area.Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
purposeEarly recognition and prompt prehospital care is a cornerstone of acute stroke treatment. Residents of rural areas have worse access to stroke services than urban residents. The purpose of this study was to (1) describe US trends in rural-urban stroke mortality and (2) identify possible factors associated with rural-urban stroke case-fatality disparities.
methodsThis study was a nationwide retrospective cohort study of stroke admissions. The primary exposure was rurality of patient's residence. The primary outcome was death during hospital encounter. The secondary outcome was discharge to a care facility or home healthcare. Univariable and multivariable logistic regressions estimated the odds of mortality by subject rurality among stroke subjects.
findingsRural stroke subjects had higher mortality than nonrural counterparts (18.6% rural vs 16.9% nonrural). After adjustment for patient and hospital factors, patient rurality was associated with increased odds of mortality (aOR = 1.11; 95% CI: 1.06-1.15; P < .001). For the secondary outcome of discharge to home, rural stroke subjects were less likely to be discharged to a care facility than nonrural stroke visits (aOR 0.94; 95% CI: 0.91-0.97; P < .001). Results were similar after adjusting for thrombolytics administration and transfer status.
conclusionsRural stroke patients have higher mortality than their urban counterparts likely due to their increased burden of chronic disease, lower health literacy, and reduced access to prompt prehospital care. There may be an opportunity for emergency medical services systems to assist in increasing stroke awareness for both patients and clinicians and to establish response patterns to expedite emergency care.
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