Chen, R;
Hu, Z;
Chen, R-L;
Zhang, D;
Xu, L;
Wang, J;
Wei, L;
(2015)
Socioeconomic deprivation and survival after stroke in China: a systematic literature review and a new population-based cohort study.
BMJ Open
, 5
(1)
, Article e005688. 10.1136/bmjopen-2014-005688.
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Abstract
Objective: To assess the association of socioeconomic deprivation (SED) with survival after stroke in China. Design: A systematic literature review and a new population-based cohort study. Setting and participants: In urban and rural communities in Anhui, China, 2978 residents aged ≥60 years took part in baseline investigation and were followed up for 5 years; five published studies were identified for a systematic review. Primary and secondary outcome measures 167 of 2978 participants (5.6%) had doctor-diagnosed stroke at baseline or 1 year later. All-cause mortality in the follow-up. Results: In the Anhui cohort follow-up of 167 patients with stroke, 64 (38.3%) died. Multivariate adjusted hazard ratio (HR) of mortality in patients with educational level of less than or equal to primary school was 1.88 (95% CI 1.05 to 3.36) compared to those having more than primary school education. Increased HR of mortality in patients living in a rural area was at borderline significant (1.64, 0.97 to 2.78), but the HR in patients with lower levels of occupation and income was not significant. Published studies showed a significant increase in stroke mortality in relation to some SED indicators. Pooled relative risk (RR) of mortality in patients with low education was 3.07 (1.27 to 7.34), in patients with low income 1.58 (1.50 to 1.65) and in patients living in rural areas 1.47 (1.37 to 1.58). Conclusions: The evidence suggests the presence of a mortality gradient after stroke for material as well as social forms of deprivation in China. Inequalities in survival after stroke persist and need to be taken into account when implementing intervention programmes.
| Type: | Article |
|---|---|
| Title: | Socioeconomic deprivation and survival after stroke in China: a systematic literature review and a new population-based cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2014-005688 |
| Publisher version: | http://dx.doi.org/10.1136/bmjopen-2014-005688 |
| Language: | English |
| Additional information: | This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1462172 |
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