The Impact of Geographic Deprivation Levels on Acute Ischemic Stroke Care in Alberta

Eagles, Matthew

The Impact of Geographic Deprivation Levels on Acute Ischemic Stroke Care in Alberta

dc.contributor.advisor	Spackman, Eldon
dc.contributor.advisor	Beall, Reed
dc.contributor.author	Eagles, Matthew
dc.contributor.committeemember	Wong, John
dc.contributor.committeemember	Hill, Michael
dc.date	2022-11
dc.date.accessioned	2022-07-14T17:05:01Z
dc.date.available	2022-07-14T17:05:01Z
dc.date.issued	2022-06
dc.description.abstract	Introduction: Acute ischemic stroke is a neurological emergency that is associated with significant morbidity and mortality. Treatments for this condition aim to reperfuse the ischemic brain and are time sensitive in nature. To optimize patient outcome, strokes need to be recognized quickly, triaged appropriately, and started down the optimal treatment pathway. Unfortunately, previous works have suggested that there are inequalities in the provision of stroke care and outcomes based on patient socioeconomic status (SES). The objective of this thesis was to assess for disparities in the management and outcomes of patients who suffer ischemic stroke in Alberta, Canada based on a measure of neighbourhood SES. Methods: We performed three retrospective cohort studies using population level data from the Quality Improvement in Clinical Research Database. All patients were treated with IV Alteplase between January 1, 2017, and December 31, 2019. The outcomes of interest were treatment with endovascular thrombectomy (EVT), patient outcome (home-time), and treatment acuity (emergency room triage scores and stroke to needle time). Our independent variable of interest was an individual’s neighbourhood deprivation, as calculated by the Pampalon Index. We used regression modeling to assess for relationships between our outcomes and independent variable of interest. Results: Overall deprivation was significantly associated with the odds of being treated with EVT, yet this difference was no longer statistically significant after controlling for the distance an individual lives from the nearest comprehensive stroke centre. There was no significant association between deprivation level and home-time or stroke to needle time; however, being from the most deprived areas of Alberta was significantly associated with less acute emergency room triage scores being assigned. Conclusions: We identified potential areas of disparity in the treatment of acute ischemic stroke based on a measure of neighbourhood SES. However, these gaps did not lead to significantly worse patient outcomes in this study cohort. Future works should attempt to replicate these findings while including patients who were not treated with Alteplase.	en_US
dc.identifier.citation	Eagles, M. (2022). The impact of geographic deprivation levels on acute ischemic stroke care in Alberta (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.	en_US
dc.identifier.doi	http://dx.doi.org/10.11575/PRISM/39912
dc.identifier.uri	http://hdl.handle.net/1880/114845
dc.language.iso	eng	en_US
dc.publisher.faculty	Cumming School of Medicine	en_US
dc.publisher.institution	University of Calgary	en
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.	en_US
dc.subject	Ischemic stroke	en_US
dc.subject	health equity	en_US
dc.subject	endovascular thrombectomy	en_US
dc.subject	patient outcomes	en_US
dc.subject.classification	Epidemiology	en_US
dc.subject.classification	Public Health	en_US
dc.title	The Impact of Geographic Deprivation Levels on Acute Ischemic Stroke Care in Alberta	en_US
dc.type	master thesis	en_US
thesis.degree.discipline	Medicine – Community Health Sciences	en_US
thesis.degree.grantor	University of Calgary	en_US
thesis.degree.name	Master of Science (MSc)	en_US
ucalgary.item.requestcopy	false	en_US