Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality
Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality
复制标题
DOI：
10.1161/strokeaha.120.029318
复制
发表时间：
2020-07-01
期刊：
影响因子：
8.3
通讯作者：
Joynt Maddox, Karen E.
中科院分区：
文献类型：
--
作者：
Hammond, Gmerice;Luke, Alina A.;Joynt Maddox, Karen E.
Background and Purpose: The rural-urban life-expectancy gap is widening, but underlying causes are incompletely understood. Prior studies suggest stroke care may be worse for individuals in more rural areas, and technological advancements in stroke care may disproportionately impact individuals in more rural areas. We sought to examine differences and 5-year trends in the care and outcomes of patients hospitalized for stroke across rural-urban strata. Methods: Retrospective cohort study using National Inpatient Sample data from 2012 to 2017. Rurality was classified by county of residence according to the 6-strata National Center for Health Statistics classification scheme. Results: There were 792 054 hospitalizations for acute stroke in our sample. Rural patients were more often white (78% versus 49%), older than 75 (44% versus 40%), and in the lowest quartile of income (59% versus 32%) compared with urban patients. Among patients with acute ischemic stroke, intravenous thrombolysis and endovascular therapy use were lower for rural compared with urban patients (intravenous thrombolysis: 4.2% versus 9.2%, adjusted odds ratio, 0.55 [95% CI, 0.51-0.59],P
