GR.3 Socioeconomical disparities in acute ischemic stroke revascularization interventions in Ontario, Canada

Abstract

Background: Lower socioeconomic status is associated with worse outcomes after stroke. We evaluated the differences in acute revascularization treatments in patients with acute ischemic stroke (AIS) who were materially deprived compared to those who were not. Methods: In a population-based cohort study, we used linked administrative data to identify community-dwelling adults hospitalized for AIS between 2017-2022 in Ontario, Canada. The main exposure was neighborhood-level material deprivation quintiles. Multivariable logistic regression was used to obtain the adjusted odds ratio (aOR) of receiving revascularization treatments (thrombolysis or thrombectomy) for patients in each deprivation quintile compared to the least deprived quintile. Results: We identified 57,709 patients (median age 74 years; 45.9% female). Compared to patients in the least deprived quintile, those with higher deprivation were younger and more likely to have hypertension and diabetes, but less likely to have atrial fibrillation. Compared to patients in the least deprived quintile, fewer patients in the very deprived quintile (17.9% vs 19.6%, aOR 0.88, 95%CI [0.82,0.95]) and in the most deprived quintile (16.6% vs 19.6%, 0.77 [0.71,0.83]) received revascularization treatments. Conclusions: Our results suggest disparities in the use of acute ischemic stroke revascularization treatments by socioeconomic status despite access to universal health care.