Stroke: Urban-rural differences in acute stroke treatment and hospitalization mortality

The gap in life expectancy between urban and rural residents is widening, but the underlying causes are not entirely clearPrevious studies have shown that individualstroketreatment in rural areas may be worse, and technological advances in stroke treatment may have a disproportionate impact on more rural populationsIn a recent study published in Stroke, an authoritative journal in the field of vasculardiseases,, researchers aimed to assess differences in treatment and outcomes and five-year trends in hospital stroke patients in urban and rural areasresearchers conducted retrospective cohort studies using national sample data from 2012-2017According to the six categories of classification scheme of the National Health Statistics Centre, rural residents are classified by county of residence792,054 hospitalizations for stroke in the study's sampleRural patients are more likely to be white (78 percent vs49 percent), older than 75 (44 percent vs40 percent), and have the lowest median income (59 percent vs32 percent) than urban patientsCompared with urban patients, the use of venous thrombosis and intravascular therapy in rural areas was lower in rural areas (venous thrombolysis: 4.2% vs 9.2%, adjustment ratio was 0.55 (95% CI is 0.51-0.59), P 0.001; intravascular therapy: 1.63% vs 2.41%, adjusted ratio is 0.64 (0.57-0.73), P 0.001) From 2012 to 2017, the urban-rural gap between the two therapies persisted Overall, the stroke mortality rate in rural areas is higher than in urban areas (6.87 per cent vs 5.82 per cent, P 0.001) Adjusted hospitalization mortality increases with increased rural population (0.97 in the suburbs compared to urban patients, P.086; large towns 1.05 (1.01-1.09), P-0.009; small towns 1.10 (1.10) .06-1.15, P 0.001; small rural cities 1.16 .11-1.21, P 0.001; From 2012 (adjusted ratio of 1.12 (1.00-1.26), P 0.001) to 2017 (adjusted ratio of 1.27 (1.13-1.42), P.001), there was no improvement in mortality rates in rural and urban patients it can be seen that rural stroke patients are less likely than urban patients to receive venous thrombosis or intravascular treatment, and the hospital mortality rate is higher These gaps have not improved over time