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Abstract Details

Impact of Socioeconomic Status on Stroke Post-discharge Outcomes
Cerebrovascular Disease and Interventional Neurology
S8 - Disparities and Outcomes in Cerebrovascular Disease (4:42 PM-4:54 PM)
007
Stroke is a leading cause of disability and death among adults, with the burden being worse in lower-middle income countries. Limited data exist on the association between SES and stroke outcomes in sub-Saharan Africa. 
To evaluate the relationship between socioeconomic status (SES) and post-discharge stroke outcomes among Zambian adults with stroke.

We conducted a prospective cohort study of consecutive adults with acute strokes in Zambia. Sociodemographic and clinical characteristics were obtained during their hospitalization.  Surviving participants were called at 90-days post- discharge, and vital status and telephone modified Rankin Scale (mRS) were completed. Good outcomes, defined as mRS ≤2, and mortality were assessed in relation to SES indicators using multivariable logistic regression models.

Of 210 participants, 55% (n=135) were female, 60% (n=126) had ischemic strokes, and average age was 56+16 years. Good outcomes at 90 days occurred in 41% (n=86) while 90-day post-discharge mortality was 20% (n=42). Higher years of education attained (p<0.001), marital status (p<0.001), fewer adults residing with the patient (p=0.02), being in formal employment (p<0.001), and higher participant (p=0.08) and household (p=0.003) monthly incomes (p<0.003) were associated with good outcomes as were younger age, hyperlipidemia, and lower admission NIH Stroke Scale score. In multivariable analysis, unemployment (OR 0.34, 95%CI 0.12-0.95, p = 0.04) and being separated (OR 0.07, 95%CI 0.0006-0.97, p=0.048) were significantly associated with poor functional outcomes, as were age (p<0.001), and higher admission NIH Stroke Scale score (p<0.001) while hyperlipidemia (p=0.04) was associated with better outcomes. Only age (p=0.001) and admission NIH Stroke Scale score (p=0.001) were independently associated with mortality.
SES indicators were not associated with higher risk of post-discharge mortality but were associated with functional outcomes.  Patients with low SES require additional post-discharge supports to maximize their chances of a good functional outcomes.
Authors/Disclosures
Musisye Luchembe
PRESENTER 		Musisye Luchembe has nothing to disclose.
Leroy Yankae, MD Leroy Yankae has nothing to disclose.
Aparna Nutakki, MD Ms. Nutakki has received research support from UJMT Fogarty Global Health Fellowship Program. Ms. Nutakki has received research support from AAN Medical Student Research Scholarship. Ms. Nutakki has received research support from Gold Humanism Student Summer Fellowship.
Melody T. Asukile, MBBS (University Teaching Hospital) Dr. Asukile has received research support from Royal Society for Tropical Medicine and Hygiene. Dr. Asukile has received personal compensation in the range of $0-$499 for serving as a meeting speaker with American Neurological Association.
Meron Gebrewold, MD (Addis Ababa University) Dr. Gebrewold has nothing to disclose.
Sarah Braun, MD (University Teaching Hospital, Lusaka, Zambia) Sarah Braun has nothing to disclose.
Lorraine Chishimba, MBChB, MMED (University Teaching Hospital) Dr. Chishimba has nothing to disclose.
Mashina Chomba, MBChB (University of Zambia) Dr. Chomba has nothing to disclose.
Mataa Mataa, MD Mataa Mataa has nothing to disclose.
Dominique Mortel, MD (Phoebe Neurology) Dr. Mortel has nothing to disclose.
Mulenga Chilando (University Teaching Hospital) Mulenga Chilando has nothing to disclose.
Dickson Munkombwe, MD (University Teaching Hospital - Adult Hospital) Dr. Munkombwe has nothing to disclose.
Frighton B. Mutete, MBChB (Livingstone University Teaching Hospital) Dr. Mutete has nothing to disclose.
Naluca Mwendaweli, MMED (University Teaching Hospital) NALUCA MWENDAWELI has nothing to disclose.
Coolwe Namangala Dr. Namangala has nothing to disclose.
Faith Simushi, MD (University Teaching Hospital) Dr. Simushi has received research support from American Neurological Association - ANA.
Stanley Zimba, MBBS (University Teaching Hospital) Dr. Zimba has nothing to disclose.
Deanna Saylor, MD, MHS (Johns Hopkins Hospital) Dr. Saylor has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from 好色先生. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and 好色先生al Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.