ArticleStroke (Hoboken, N.J.)2023
Stroke Severity Mediates the Association Between Socioeconomic Disadvantage and Poor Outcomes Among Patients With Acute Ischemic Stroke.
Article in Stroke (Hoboken, N.J.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Factors Underlying Stroke Recovery Variation by Neighborhood Socioeconomic Status.JAMA network open · 2026Article
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11 authors.
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Abstract
Background: Impact of mediating factors on the relationship between socioeconomic disadvantage and outcomes among patients with acute ischemic stroke has not been well characterized. Methods: Data on patients with acute ischemic stroke were extracted from electronic medical records, and 90-day modified Rankin scale (mRS) scores were collected as part of a prospective stroke registry. Exact patient addresses were geocoded and characterized using Area Deprivation Index (ADI) ranks. The 90-day modified Rankin scale scores ≥3 were categorized as poor outcomes. Logistic regression models (adjusted for treatment with intravenous tissue plasminogen activator or intraarterial therapy, sociodemographics, and comorbidities) were fitted to compute adjusted odds ratios (aORs) and 95% CIs for total effect of high ADI on poor outcomes. In-hospital mortality (versus survived) and unfavorable (versus favorable) discharge disposition were also evaluated as outcomes. Structural equation modeling was used to report the average causal mediation effects of stroke severity (National Institutes of Health Stroke Scale [NIHSS]) and treatment (intravenous tissue plasminogen activator or intraarterial therapy). Results: Between May 2016 and December 2021, 13 641 patients with acute ischemic stroke (median age, 69 years; 50.1% women) were included. Among 3002 patients with functional outcomes data, a high ADI was significantly associated with poor 90-day modified Rankin scale score (aOR, 1.16 [95% CI, 1.04-1.29]). Patients in higher ADI neighborhoods had increased odds of having higher NIHSS scores (aOR, 1.19 [95% CI, 1.07-1.32]). Likewise, a higher NIHSS score was associated with poor 90-day modified Rankin scale score (aOR, 9.34 [95% CI, 7.64-11.5]). The effect of neighborhood disadvantage on poor 90-day modified Rankin scale score was 59% mediated by NIHSS score (average causal mediation effects: Conclusions: Neighborhood disadvantage leads to unfavorable hospital discharges and worse 90-day disability, mediated via stroke severity. Tracking social determinants of health may identify opportunities for reducing the onset of severe strokes and poor outcomes.
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