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Associations between socioeconomic status and place of residence with survival after aneurysmal subarachnoid haemorrhage


Nichols, L and Gall, S and Stankovich, J and Stirling, C, Associations between socioeconomic status and place of residence with survival after aneurysmal subarachnoid haemorrhage, Internal Medicine Journal Article online ahead of print. ISSN 1444-0903 (2020) [Refereed Article]

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This article is protected by copyright. All rights reserved

DOI: doi:10.1111/imj.15044


Objectives: This study aims to understand early (< 24 h post ictus) and late (up to 12 months) survival post aneurysmal subarachnoid haemorrhage (aSAH), with a focus on rurality and socioeconomic status.

Methods: A statewide population-based cohort of aSAH cases in Tasmania, Australia, was established from 2010-2014 utilising multiple overlapping sources. Clinical data were collected from medical records and the Tasmanian Death Registry, with area-level rurality and socioeconomic status geocoded to participants' residential address.

Results: From a cohort of 237 (70% women, 36% disadvantaged, 38% rural) individuals over a 5-year period, 12-month mortality was 52.3% with 54.0% of these deaths occurring within 24 h post ictus. In univariable analysis of 12-month survival, outcome was not influenced by socioeconomic status but rural geographical location was associated with a non-significant increase in death (HR 1.22 95% CI 0.85-1.75) along with hypertension (HR 1.78 95% CI 1.07-2.98) and hypercholesterolemia (HR 1.70 95% CI 0.99-2.91). Multivariable analysis demonstrated a statistically significant increase in death to 12 months after aSAH for both hypertension (HR 1.81 95% CI 1.08-3.03) and hypercholesterolemia (HR 1.71 95% CI 1.00-2.94) but not socioeconomic status or geographic location.

Conclusion: We found high early death in this population-based aSAH Australian population. Survival to 12 months after aSAH was not related to either geographical location or socioeconomic status but modifiable risk factors increased the risk of death.

Item Details

Item Type:Refereed Article
Keywords:aneurysmal subarachnoid haemorrhage, time to treatment, inequalities
Research Division:Health Sciences
Research Group:Public health
Research Field:Health equity
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Nichols, L (Mrs Linda Nichols)
UTAS Author:Gall, S (Associate Professor Seana Gall)
UTAS Author:Stirling, C (Professor Christine Stirling)
ID Code:145006
Year Published:2020
Funding Support:National Health and Medical Research Council (1143155)
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-06-24
Last Modified:2021-09-02

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