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Eur J Neurol ; 18(8): 1094-7, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21749574

RESUMO

BACKGROUND: Socioeconomic status is thought to have a significant influence on stroke incidence, risk factors and outcome. Its influence on acute stroke severity, stroke mechanisms, and acute recanalisation treatment is less known. METHODS: Over a 4-year period, all ischaemic stroke patients admitted within 24h were entered prospectively in a stroke registry. Data included insurance status, demographics, risk factors, time to hospital arrival, initial stroke severity (NIHSS), etiology, use of acute treatments, short-term outcome (modified Rankin Scale, mRS). Private insured patients (PI) were compared with basic insured patients (BI). RESULTS: Of 1062 consecutive acute ischaemic stroke patients, 203 had PI and 859 had BI. They were 585 men and 477 women. Both populations were similar in age, cardiovascular risk factors and preventive medications. The onset to admission time, thrombolysis rate, and stroke etiology according to TOAST classification were not different between PI and BI. Mean NIHSS at admission was significantly higher for BI. Good outcome (mRS≤2) at 7days and 3months was more frequent in PI than in BI. CONCLUSION: We found better outcome and lesser stroke severity on admission in patients with higher socioeconomic status in an acute stroke population. The reason for milder strokes in patients with better socioeconomic status in a universal health care system needs to be explained.


Assuntos
Instituições Privadas de Saúde/economia , Disparidades em Assistência à Saúde/economia , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/tendências , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/economia , Idoso , Idoso de 80 Anos ou mais , Feminino , Custos de Cuidados de Saúde/tendências , Instituições Privadas de Saúde/tendências , Acessibilidade aos Serviços de Saúde/tendências , Disparidades em Assistência à Saúde/tendências , Hospitais Privados/economia , Hospitais Privados/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/métodos , Estudos Prospectivos , Índice de Gravidade de Doença , Acidente Vascular Cerebral/mortalidade , Suíça/epidemiologia
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