Effect of social deprivation on mortality and the duration of hospital

Abstract

Background: We aim to assess whether social deprivation independently predicts case fatality after a stroke patient has been admitted to hospital, and to assess whether social deprivation affected duration of hospital stay. Methods: Cohort study in a tertiary teaching hospital included consecutive patients admitted to hospital within 48 h of their stroke between 1988 and 1994. Outcome measures were case fatality at 1 year and length of hospital stay. The socioeconomic category was derived from the postcode sector of residence for the patients (Carstairs index). Cause of death was determined by data linkage to the Registrar General data for Scotland. Results: 2,042 stroke patients were included. A significant age difference existed between the deprivation categories (76.0 +/- 10.9 years in the affluent cohort vs. 71.4 +/- 10.7 years in the deprived cohort). Smoking was more common in the deprived group. ECG findings and neurological score on admission were similar between the groups. No difference existed between groups for length of hospital stay (p = 0.793), and in the proportions remaining alive at 1 year (p = 0.416). When entered into a multivariate Cox regression analysis, the deprivation categories did not predict mortality. Age, sex, Philadelphia Geriatric Center Instrumental Activities of Daily Living (IADL) Scale Score, Orgogozo neurological score on admission, and ECG abnormalities were the significant predictors. Conclusions: Stroke patients living in more socially deprived areas had their strokes at an earlier age but were not at a greater risk of dying or longer hospital stay once they had been admitted to hospital. Copyright (c) 2006 S. Karger AG, Basel.

C1 Univ Dundee, Ninewells Hosp & Med Sch, Stroke Studies Ctr, Div Med & Therapeut,Cardiovasc Epidemiol Unit, Dundee DD1 9SY, Scotland.

Ninewells Hosp, Div Med & Therapeut, Dept Clin Pharmacol & Therapeut, Dundee DD1 9SY, Scotland.

Ninewells Hosp, Div Med & Therapeut, Stroke Studies Ctr, Dundee DD1 9SY, Scotland.

Inonu Univ, Fac Med, Turgut Ozal Med Ctr, Dept Phys Med & Rehabil, Malatya, Turkey.

Univ St Andrews, Dept Epidemiol & Publ Hlth, St Andrews, Fife, Scotland.

Univ St Andrews, Dept Management, St Andrews, Fife, Scotland.