London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 671 Table 1: Areas under the ROC curves for prediction of functional outcome at 3 months poststroke Prediction model Excellent outcome (mRS 0-1) Good outcome (mRS 0-2) Catastrophic out-come (mRS 5-6) s-TPI 0.80 (0.73-0.87) 0.83 (0.77-0.89) 0.86 (0.80-0.92) MMS 0.69 (0.59-0.79) 0.74 (0.66-0.82) 0.74 (0.66-0.81) HAT 0.74 (0.67-0.82) 0.78 (0.71-0.85) 0.78 (0.71-0.86) SITS SICH 0.68 (0.59-0.78) 0.74 (0.67-0.82) 0.72 (0.64-0.80) iSCORE 0.72 (0.63-0.80) 0.80 (0.73-0.87) 0.86 (0.80-0.92) SEDAN 0.74 (0.66-0.83) 0.78 (0.70-0.85) 0.75 (0.67-0.83) DRAGON 0.79 (0.71-0.87) 0.82 (0.76-0.89) 0.81 (0.74-0.88) GRASPS 0.78 (0.70-0.86) 0.81 (0.75-0.88) 0.86 (0.80-0.92) Values are c-statistics (95% Confidence interval) DRAGON, Dense cerebral artery prestroke modified Rankin scale Age Glucose Onset-to-treatment time NIHSS score; GRASPS, Glucose Race Age Sex Pressure stroke Severity; HAT, Hemorrhage after Thrombolysis score; MMS, Multicenter Stroke Survey score; SITS SICH, Safe Implementation of Treatments in Stroke Symptomatic Intracerebral Hemorrhage score; SEDAN, Sugar Early infarct Dense cerebral artery Age NIHSS score ; s-TPI, Stroke-Thrombolytic Predictive Instrument. 614 Acute stroke: emergency management, stroke units and complications Socioeconomic inequalities in access to stroke thrombolysis - observations in the Swedish stroke register (Riks-Stroke) A. Stecksén1, K. Asplund2, E-L. Glader3, B. Norrving4, M. Eriksson5 Umeå University, Umeå, SWEDEN1, Umeå University, Stockholm, SWEDEN2, Umeå University, Umeå, SWEDEN3, Lund University, Lund, SWEDEN4, Umeå University, Umeå5 Background: Previous studies show regional and sex differences in the implementation of thrombo-lytic therapy for acute ischemic stroke. We used Riks-Stroke, the Swedish Stroke Register, to test the hypothesis that higher socioeconomic position is associated with increased access to thromboly-sis. Methods: This study included 85 885, 18-80 year old ischemic stroke patients, admitted to Swedish hospitals, registered in the national stroke register, Riks-Stroke, 2003-2009. Individual patient infor-mation on socioeconomic status (education and income) was retrieved from Statistics Sweden. Data on thrombolysis and other patient characteristics was acquired from Riks-Stroke. Multiple logistic regression was used to analyze the association between thrombolysis and socioeconomic status, adjusting for potential confounding factors (year, sex, age, level of consciousness, dependence in p-ADL, history of stroke, atrial fibrillation and diabetes). Results: Patients with university education were more likely to receive thrombolytic therapy (5.4%) than patients with secondary (4.6%) or primary school education (3.6%, p<0.001). A similar dif-ference was seen between the 10% of patients with highest and the 10% with lowest income (6.4% vs. 4.7%, p<0.001). The inequality associated with education was still present after adjustment for other patient characteristics. The odds ratio of receiving thrombolysis was 1.15 (95% CI: 1.04-1.28) for university and 1.09 (1.00-1.18) for secondary school compared to primary school education. The absolute difference between the groups with lowest and highest education remained similar be-tween 2003 (0.6% vs. 1.9%) and 2009 (7.7% vs. 9.7%), although the relative differences decreased (p=0.005). Conclusion: Patients with higher education have better access to stroke thrombolysis, the inequality remains although the relative difference have been reduced over the time.
Karger_ESC London_2013
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