This Article Full Text Full Text (PDF) All Versions of this Article: 36/2/310    most recent 01.STR.0000152962.92621.b5v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Arrich, J. Articles by Müllner, M. Search for Related Content PubMed PubMed Citation Articles by Arrich, J. Articles by Müllner, M. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Other Ethics and Policy Acute Cerebral Infarction Acute Stroke Syndromes

(Stroke. 2005;36:310.)
© 2005 American Heart Association, Inc.

Original Contributions

Influence of Socioeconomic Status on Mortality After Stroke

Retrospective Cohort Study

From the Department of Emergency Medicine (J.A., M.M.) and Clinical Department of Clinical Neurology (W.L.), Medical University of Vienna, Vienna General Hospital, Vienna, Austria.

Correspondence to Dr Marcus Müllner, Universitätsklinik für Notfallmedizin, Allgemeines Krankenhaus, Wien, Währinger Gürtel 18-20/6D, 1090 Wien, Austria. E-mail marcus.muellner{at}meduniwien.ac.at

Background and Purpose— Low socioeconomic status is associated with increased morbidity and mortality from stroke. The purpose of this study was to investigate the association between 4 independent measures of socioeconomic status and mortality of patients with acute ischemic stroke and transient ischemic attack.

Methods— Socioeconomic status was assessed by taking into account levels of education, occupation, occupational status, and income. The end point was overall mortality. We used Cox proportional hazard models to adjust for age, sex, and severity of stroke on admission.

Results— A total of 2606 stroke patients were followed up for a median of 2.5 years. Unskilled workers had a hazard ratio of 1.87 for death after stroke (95% CI, 1.37 to 2.55) and skilled workers had a hazard ratio of 1.61 (95% CI, 1.23 to 2.11) compared with white-collar workers. Of 4 income groups, patients with the second lowest level of income had a hazard ratio of 1.60 (95% CI, 1.10 to 2.33) and patients with the third lowest level of income had a hazard ratio of 1.71 (95% CI, 1.25 to 2.32) compared with patients with the highest income. The hazard ratio for death after stroke for early retired patients was 1.75 (95% CI, 1.01 to 3.04) compared with stroke patients in the active workforce at the time of the event.

Conclusions— Socioeconomic status is associated with survival of patients with acute stroke after adjustment for age, sex, and severity of stroke. The influence of socioeconomic status seems to continue to affect the outcome largely independent of stroke severity.

Key Words: ischemic attack, transient • mortality • socioeconomic factors • stroke

This article has been cited by other articles:

				G. Cesaroni, N. Agabiti, F. Forastiere, and C. A. Perucci Socioeconomic Differences in Stroke Incidence and Prognosis Under a Universal Healthcare System Stroke, August 1, 2009; 40(8): 2812 - 2819. [Abstract] [Full Text] [PDF]

				R. Raine, W. Wong, G. Ambler, S. Hardoon, I. Petersen, R. Morris, M. Bartley, and D. Blane Sociodemographic variations in the contribution of secondary drug prevention to stroke survival at middle and older ages: cohort study BMJ, April 16, 2009; 338(apr16_2): b1279 - b1279. [Abstract] [Full Text] [PDF]

				G. Saposnik, T. Jeerakathil, D. Selchen, A. Baibergenova, V. Hachinski, M. K. Kapral, and for the Stroke Outcome Research Canada (SORCan) Wo Socioeconomic Status, Hospital Volume, and Stroke Fatality in Canada Stroke, December 1, 2008; 39(12): 3360 - 3366. [Abstract] [Full Text] [PDF]

				J. Arrich, M. Mullner, W. Lalouschek, S. Greisenegger, R. Crevenna, and H. Herkner Influence of Socioeconomic Status and Gender on Stroke Treatment and Diagnostics Stroke, July 1, 2008; 39(7): 2066 - 2072. [Abstract] [Full Text] [PDF]

				J. E. Williams, M. I. Chimowitz, G. A. Cotsonis, M. J. Lynn, S. P. Waddy, and for the WASID Investigators Gender Differences in Outcomes Among Patients With Symptomatic Intracranial Arterial Stenosis Stroke, July 1, 2007; 38(7): 2055 - 2062. [Abstract] [Full Text] [PDF]