Introduction/Purpose A number of social determinants of health (SDOH) have been identified that impact neurosurgical disease prevalence and outcomes. The area deprivation index (ADI) is a measure used to assess the level of deprivation in a geographical area. The aim of this study was to report differences in more and less disadvantaged populations and analyze the relationship between ADI scores and mechanical thrombectomy (MT) outcomes in patients with acute ischemic stroke (AIS).
Materials and Methods Our prospectively maintained endovascular database was retrospectively searched for AIS patients who underwent MT. Demographics and outcomes data were collected along with identification of SDOH factors. The ADI scores were identified based on patient zip codes, and the study population was divided into more and less disadvantaged cohorts. Univariate and multivariate logistic regression analysis was completed for demographics and outcomes.
Results This study included 635 patients: 336(52.9%) in the less disadvantaged group and 299(47.1%) in the more disadvantaged group. Patients in the more disadvantaged group were significantly older than those in the less disadvantaged group (69.02±13.96 years vs. 71.29±15.05 years; p=0.05). Patients in the more disadvantaged group had a significantly longer symptom-to-door time than the less disadvantaged group (200.64±279.25 minutes vs. 141.73±211.73 minutes; p=0.006). Patients in the more disadvantaged group had longer hospital stays than patients in the less disadvantaged group (11.74±23.49 days vs. 8.66±9.79 days; p=0.04). However, there were no differences in TICI grade outcomes (p=0.31), or rate of vasospasm (p=0.77), dissection (p=0.88), stroke complication (p=0.73), or total ICH (p=0.98) between the more disadvantaged group and the less disadvantaged group (table 1). Further, there was no difference in the 90-day mortality rate (p=0.72) or mRS score (p=0.13).
Conclusion We found that despite differences in baseline characteristics, patients from more and less disadvantaged groups received similar treatment resulting in comparable clinical and radiographic outcomes following MT for AIS.
Disclosures A. Baig: None. A. Aguirre: None. D. Patel: None. J. Lim: None. B. Donnelly: None. R. Turner: None. K. Raygor: None. M. Bouslama: None. P. Lai: None. W. Khawar: None. J. Davies: 1; C; NIH NINDS, NSF SBIR. 2; C; Medtronic; Honoraria. 4; C; Synchron, Cerebrotech, QAS.ai, RIST. E. Levy: 2; C; Claret Medical, GLG Consulting, Guidepoint Global, Imperial Care, Medtronic, Rebound, StimMed, Misionix, Mosiac, and others. 4; C; NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, and others. A. Siddiqui: 2; C; Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., Cerenovus, and others. 4; C; Adona Medical, Inc., Amnis Therapeutics, Bend IT Technologies, Ltd., BlinkTBI, Inc, Buffalo Technology Partners, Inc., Cardinal Consultants, LLC, Cerebrotech Medical Systems, Inc, and others.
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