Abstract：
UNASSIGNED: There is a well-known association between low socioeconomic status (SES), poor survival, and clinician-reported outcomes after stroke. We aimed to assess socioeconomic differences in Patient Reported Outcome Measures 3 months after stroke.
UNASSIGNED: This nationwide cohort study included patients registered with acute stroke in the Swedish Stroke Register 2015-2017. Patient Reported Outcome Measures included activities of daily living (mobility, toileting, and dressing), and poststroke symptoms (low mood, fatigue, pain, and poor general health). Information on SES prestroke was retrieved from Statistics Sweden and defined by a composite measure based on education and income tertiles. Associations between SES and Patient Reported Outcome Measures were analyzed using logistic regression adjusting for confounders (sex and age) and additionally for potential mediators (stroke type, severity, cardiovascular disease risk factors, and living alone). Subgroup analyses were performed for stroke type, men and women, and younger and older patients.
UNASSIGNED: The study included 44 511 patients. Of these, 31.1% required assistance with mobility, 18% with toileting, and 22.2% with dressing 3 months after stroke. For poststroke symptoms, 12.3% reported low mood, 39.1% fatigue, and 22.7% pain often/constantly, while 21.4% rated their general health as poor/very poor. Adjusted for confounders, the odds of needing assistance with activities of daily living were highest for patients with low income and primary school education, for example, for mobility, odds ratio was 2.06 (95% CI, 1.89-2.24) compared with patients with high income and university education. For poststroke symptoms, odds of poor outcome were highest for patients with low income and university education (eg, odds ratio, 1.79 [95% CI, 1.49-2.15] for low mood). Adjustments for potential mediators attenuated but did not remove associations. The associations were similar in ischemic and hemorrhagic strokes and more pronounced in men and patients <65 years old.
UNASSIGNED: There are substantial SES-related differences in Patient Reported Outcome Measures poststroke. The more severe outcome associated with low SES is more pronounced in men and in patients of working age.
UNASSIGNED: This nationwide cohort study included patients registered with acute stroke in the Swedish Stroke Register 2015-2017. Patient Reported Outcome Measures included activities of daily living (mobility, toileting, and dressing), and poststroke symptoms (low mood, fatigue, pain, and poor general health). Information on SES prestroke was retrieved from Statistics Sweden and defined by a composite measure based on education and income tertiles. Associations between SES and Patient Reported Outcome Measures were analyzed using logistic regression adjusting for confounders (sex and age) and additionally for potential mediators (stroke type, severity, cardiovascular disease risk factors, and living alone). Subgroup analyses were performed for stroke type, men and women, and younger and older patients.
UNASSIGNED: The study included 44 511 patients. Of these, 31.1% required assistance with mobility, 18% with toileting, and 22.2% with dressing 3 months after stroke. For poststroke symptoms, 12.3% reported low mood, 39.1% fatigue, and 22.7% pain often/constantly, while 21.4% rated their general health as poor/very poor. Adjusted for confounders, the odds of needing assistance with activities of daily living were highest for patients with low income and primary school education, for example, for mobility, odds ratio was 2.06 (95% CI, 1.89-2.24) compared with patients with high income and university education. For poststroke symptoms, odds of poor outcome were highest for patients with low income and university education (eg, odds ratio, 1.79 [95% CI, 1.49-2.15] for low mood). Adjustments for potential mediators attenuated but did not remove associations. The associations were similar in ischemic and hemorrhagic strokes and more pronounced in men and patients <65 years old.
UNASSIGNED: There are substantial SES-related differences in Patient Reported Outcome Measures poststroke. The more severe outcome associated with low SES is more pronounced in men and in patients of working age.
摘要：
■低社会经济地位(SES)之间存在着众所周知的关联，生存不佳,和临床医生报告的卒中后结局。我们旨在评估卒中后3个月患者报告结局指标的社会经济差异。
■这项全国性队列研究纳入了2015-2017年瑞典卒中注册的急性卒中患者。患者报告的结果措施包括日常生活活动(流动性，如厕,和敷料)，和中风后症状（情绪低落，疲劳,疼痛,和整体健康状况不佳)。有关SES卒中前的信息从瑞典统计局检索，并通过基于教育和收入的综合度量来定义。SES和患者报告的结局指标之间的关联进行了分析，使用逻辑回归校正混杂因素（性别和年龄），另外还校正了潜在的介质（卒中类型，严重程度,心血管疾病危险因素，独自生活）。对卒中类型进行亚组分析，男人和女人,年轻和老年患者。
■该研究包括44511名患者。其中,31.1%需要流动性方面的援助，18%的人如厕，中风后3个月换药的比例为22.2%。对于中风后的症状，12.3%的人表示情绪低落，39.1%疲劳,和22.7％的疼痛经常/不断，21.4%的人认为他们的总体健康状况较差/非常差。针对混杂因素进行了调整，低收入和小学教育的患者需要日常生活活动援助的可能性最高，例如,对于移动性，与高收入和大学学历的患者相比,比值比为2.06(95%CI,1.89-2.24).对于中风后的症状，低收入和大学教育的患者预后不良的几率最高(例如，赔率比,情绪低落为1.79[95%CI，1.49-2.15]）。对潜在介质的调整减弱，但没有消除关联。缺血性和出血性中风的相关性相似，在男性和<65岁的患者中更为明显。
■卒中后患者报告的结局指标存在显著的SES相关差异。与低SES相关的更严重的结果在男性和工作年龄的患者中更为明显。
■这项全国性队列研究纳入了2015-2017年瑞典卒中注册的急性卒中患者。患者报告的结果措施包括日常生活活动(流动性，如厕,和敷料)，和中风后症状（情绪低落，疲劳,疼痛,和整体健康状况不佳)。有关SES卒中前的信息从瑞典统计局检索，并通过基于教育和收入的综合度量来定义。SES和患者报告的结局指标之间的关联进行了分析，使用逻辑回归校正混杂因素（性别和年龄），另外还校正了潜在的介质（卒中类型，严重程度,心血管疾病危险因素，独自生活）。对卒中类型进行亚组分析，男人和女人,年轻和老年患者。
■该研究包括44511名患者。其中,31.1%需要流动性方面的援助，18%的人如厕，中风后3个月换药的比例为22.2%。对于中风后的症状，12.3%的人表示情绪低落，39.1%疲劳,和22.7％的疼痛经常/不断，21.4%的人认为他们的总体健康状况较差/非常差。针对混杂因素进行了调整，低收入和小学教育的患者需要日常生活活动援助的可能性最高，例如,对于移动性，与高收入和大学学历的患者相比,比值比为2.06(95%CI,1.89-2.24).对于中风后的症状，低收入和大学教育的患者预后不良的几率最高(例如，赔率比,情绪低落为1.79[95%CI，1.49-2.15]）。对潜在介质的调整减弱，但没有消除关联。缺血性和出血性中风的相关性相似，在男性和<65岁的患者中更为明显。
■卒中后患者报告的结局指标存在显著的SES相关差异。与低SES相关的更严重的结果在男性和工作年龄的患者中更为明显。
