Neighbourhood deprivation, distance to nearest comprehensive stroke centre and access to endovascular thrombectomy for ischemic stroke: a population-based study

Article Figures & Tables

Download figure
Open in new tab
Download powerpoint
Figure 1:
Combination of material and social deprivation quintiles (Qs) to create a 5-group ordinal variable. Reproduced from Gamache et al. (26) with permission. Note: DA = dissemination area.
Download figure
Open in new tab
Download powerpoint
Figure 2:
Box plot showing relation between socioeconomic deprivation level and log-transformed distance to the nearest comprehensive stroke centre (CSC). Distance log was transformed for graphical purposes to better illustrate differences. Level 1 = least deprived, level 5 = most deprived.
Download figure
Open in new tab
Download powerpoint
Figure 3:
Logistic regression lines of best fit showing the predicted proportion of patients who would receive endovascular thrombectomy (EVT) based on the distance they lived from the nearest comprehensive stroke centre (CSC), stratified by deprivation level. Each line represents a separate within-deprivation-level logistic regression model.

Table 1:

Baseline and clinical characteristics of the study cohort

Characteristic	No. (%) of patients^*
Characteristic	Total n = 1335	Complete case analysis n = 1154
Age, median (IQR), yr	72 (21)	72 (20)
Male sex	731 (54.8)	644 (55.8)
Pre-alteplase NIHSS score, median (IQR)	9 (11)	9 (11)
Distance to nearest CSC, median (IQR), km	23 (128)	21 (126)
Deprivation quintile
1 (least deprived)	157 (11.8)	156 (13.5)
2	251 (18.8)	247 (21.4)
3	308 (23.1)	300 (26.0)
4	220 (16.5)	212 (18.4)
5 (most deprived)	247 (18.5)	241 (20.8)
Missing	152 (11.4)	0 (0.0)
EVT attempted	314 (23.5)	276 (23.9)

Note: CSC = comprehensive stroke centre, EVT = endovascular thrombectomy, IQR = interquartile range, NIHSS = National Institutes of Health Stroke Scale.
↵* Except where noted otherwise.

Table 2:

Regression analysis of odds of being treated with endovascular thrombectomy

Variable	Bivariate model, unadjusted OR (95% CI)	Primary model, adjusted OR (95% CI)^*	Secondary model, adjusted OR (95% CI)
Deprivation quintile
1 (least deprived)	Reference	Reference	Reference
2	0.89 (0.56 to 1.41)	0.89 (0.52 to 1.53)	1.07 (0.62 to 1.88)
3	1.00 (0.65 to 1.56)	0.96 (0.58 to 1.62)	1.02 (0.60 to 1.74)
4	0.90 (0.56 to 1.43)	0.75 (0.43 to 1.32)	0.86 (0.48 to 1.54)
5 (most deprived)	0.53 (0.32 to 0.87)	0.43 (0.24 to 0.77)	0.60 (0.33 to 1.10)
Age	NA	0.98 (0.97 to 0.99)	0.98 (0.97 to 0.99)
Male sex	NA	1.03 (0.75 to 1.43)	0.99 (0.70 to 1.39)
Pre-alteplase NIHSS score	NA	1.20 (1.17 to 1.23)	1.22 (1.19 to 1.25)
Distance to nearest CSC	NA	NA	0.99 (0.99 to 0.99)

Note: CI = confidence interval, CSC = comprehensive stroke centre, NA = not applicable, NIHSS = National Institutes of Health Stroke Scale, OR = odds ratio.
↵* Adjusted for age, sex and stroke severity.
† Adjusted for age, sex, stroke severity and distance to the nearest CSC.