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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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 Type:||Refereed Article|
|Keywords:||aneurysmal subarachnoid haemorrhage, time to treatment, inequalities|
|Research Division:||Health Sciences|
|Research Group:||Public health|
|Research Field:||Health equity|
|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)|
|Funding Support:||National Health and Medical Research Council (1143155)|
|Deposited By:||Menzies Institute for Medical Research|
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