Abstract 3450: Low Education as a Predictor Of Poor 1-year Stroke Survival In The Emma Study (study Of Stroke Mortality And Morbidity In Adults), Brazil
Low education as a predictor of poor 1-year stroke survival in the EMMA Study (Study of Stroke Mortality and Morbidity in Adults), Brazil Background and purpose-socioeconomic status plays an important role in stroke trends. This study aimed to investigate educational level as a surrogate to explain differences in stroke survival.
Hypothesis: to verify if stroke survival is influenced by educational level. Methods-we prospectively ascertained 430 consecutive first-ever stroke patients (ischemic and haemorrhagic) enrolled in the Stroke Mortality and Morbidity Study (The EMMA study) between April 2006 and December 2008 in a community hospital in São Paulo, Brazil, and stratified them according to educational level (illiterate, 1-7 years, ≥8 years). Results- stroke survival rate was 74.9% at one-year follow-up. The risk for fatal stroke inversely correlated with years of education (multivariate hazard ratio comparing non educated group with ≥8 years of education group = 2.06; 95% CI, 1.18-3.60, P for trend=0.01). The gradient was more pronounced for ischemic stroke (hazard ratio=2·32; 95%CI, 1.26-4.27, P=0.01). This association was even stronger after adjusting by sociodemographic, cardiovascular risk factors and in the full model (hazard ratio = 2.67, 2.43, and 2.65, respectively). No education was associated with an increased risk of fatal stroke for patients who were less than 68 years old (hazard ratio=3.67; 95% CI, 1.10-12.45), female (hazard ratio=3.42; 95% IC, 1.10-12.45), lived alone (hazard ratio=2.78; 95% CI, 1.16-6.66) and smoked (hazard ratio=4.27; 95% IC, 1.28-14.19).Conclusions-stroke survival was directly related to years of education, especially for ischemic stroke. Absence of education was a significant marker of fatal stroke in persons under age 68 years, who live alone, and who smoked.
- © 2012 by American Heart Association, Inc.