Social and health determinants related to adverse short-term outcomes after a first-ever stroke in adults younger than 65 years

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dc.contributor.authorLopez-Espejo, Mauricio
dc.contributor.authorPoblete, Rodrigo
dc.contributor.authorBastias, Gabriel
dc.date.accessioned2025-01-20T20:09:50Z
dc.date.available2025-01-20T20:09:50Z
dc.date.issued2023
dc.description.abstractBackground: Stroke-related mortality and disability-adjusted life years in adults younger than 65 have increased over the last decade. However, geographical differ-ences in distributing these outcomes could reflect dissimilarity in determinants. Therefore, this cross-sectional study of secondary data from Chilean hospitals aims to analyze the association of sociodemographic and clinical factors with in-hospital case-fatality risk or acquired neurologic deficits (adverse outcomes) in inpatients aged 18 to 64 who experienced their first-ever stroke. Methodology: Adjusted multi -variable logistic regression models and interaction analysis using multiple imputa-tion for missing data (4.99%) for 1,043 hospital discharge records from the UC-CHRISTUS Health Network International Refined Diagnosis Related Groups (IR-DRG) system database (2010-2021) were conducted. Results: Mean age: 51.47 years (SD, 10.79); female: 39.60%. Stroke types: subarachnoid hemorrhage (SAH): 5.66%, intracerebral hemorrhage (ICH): 11.98%, and ischemic: 82.45%. Adverse outcomes: 25.22% (neurological deficit: 23.59%; in-hospital case-fatality risk: 1.63%). After adjusting for confounders, adverse outcomes were associated with stroke type (patients with ICH and ischemic stroke had higher odds than those with SAH), soci-odemographic characteristics (age = 40 years, residence in an area of the capital city other than the center-east, and coverage by public health insurance), and discharge diagnoses (obesity, coronary artery and chronic kidney diseases, and mood and anxiety disorders). For hypertension, women had higher odds of adverse outcomes. Conclusions: In this predominantly Hispanic sample, modifiable social and health determinants are related to adverse short-term outcomes after a first-ever stroke. Longitudinal studies are needed to investigate the causal role of these factors.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2023.107153
dc.identifier.eissn1532-8511
dc.identifier.issn1052-3057
dc.identifier.urihttps://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107153
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92022
dc.identifier.wosidWOS:001012174200001
dc.issue.numero8
dc.language.isoen
dc.revistaJournal of stroke & cerebrovascular diseases
dc.rightsacceso restringido
dc.subjectCerebrovascular disease
dc.subjectRisk factors
dc.subjectYoung adult
dc.subjectNeurological sequelae
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleSocial and health determinants related to adverse short-term outcomes after a first-ever stroke in adults younger than 65 years
dc.typeartículo
dc.volumen32
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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