Stroke initial severity and outcome relative to insurance status in a universal health care system in Switzerland.

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State: Public
Version: author
Serval ID
serval:BIB_7556FD0787E5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Stroke initial severity and outcome relative to insurance status in a universal health care system in Switzerland.
Journal
European Journal of Neurology
Author(s)
Rey Vincianne, Faouzi Mohamed, Huchmand-Zadeh Mitra, Michel Patrik
ISSN
1468-1331 (Electronic)
ISSN-L
1351-5101
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
18
Number
8
Pages
1094-1097
Language
english
Abstract
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 24 h 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 7 days and 3 months 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.
Pubmed
Web of science
Open Access
Yes
Create date
26/08/2011 6:49
Last modification date
20/08/2019 14:32
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