The association between social networks and functional recovery after stroke.

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY International Journal of Stroke Pub Date : 2024-09-23 DOI:10.1177/17474930241283167
Lauri Bishop, Scott C Brown, Hannah E Gardener, Antonio J Bustillo, D Akeim George, Gillian Gordon Perue, Karlon H Johnson, Neva Kirk-Sanchez, Negar Asdaghi, Carolina M Gutierrez, Tatjana Rundek, Jose G Romano
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Abstract

Background and purpose: Social determinants of health (SDOH), including social networks, impact disability and quality of life post-stroke, yet the direct influence of SDOH on functional change remains undetermined. We aimed to identify which SDOH predict change on the modified Rankin Scale (mRS) within 90 days after stroke hospitalization.

Methods: Stroke patients from the Transitions of Care Stroke Disparities Study (TCSDS) were enrolled from 12 hospitals in the Florida Stroke Registry. TCSDS aims to identify disparities in hospital-to-home transitions after stroke. SDOH were collected by trained interviewers at hospital discharge. The mRS was assessed at discharge, 30- and 90-day post-stroke. Multinomial logistic regression models examined contributions of each SDOH to mRS improvement or worsening (compared to no change) from discharge to 30- and 90-day, respectively.

Results: Of 1190 participants, median age was 64 years, 42% were women, 52% were non-Hispanic White, and 91% had an ischemic stroke. Those with a limited social support network had greater odds of functional decline at 30 days (aOR = 1.39, 1.17-1.66), adjusting for age and onset to arrival time and at 90 days (aOR = 1.50, 1.10-2.05) after adjusting for age. Results were consistent after further adjustment for additional SDOH and participant characteristics. Individuals living with a spouse/partner had reduced odds of functional decline at 90 days (aOR = 0.74, 0.57-0.98); however, results were inconsistent with more conservative modeling approaches.

Conclusion: The findings highlight the importance of SDOH, specifically having a greater number of individuals in your social network in functional recovery after stroke.

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中风后社交网络与功能恢复之间的关联。
背景和目的:健康的社会决定因素(SDOH),包括社会网络会影响中风后的残疾和生活质量,但 SDOH 对功能变化的直接影响仍未确定。我们旨在确定哪些 SDOH 可预测中风住院后 90 天内修正的 Rankin 量表(mRS)的变化:方法:从佛罗里达州卒中登记处的 12 家医院中招募了来自 "卒中差异过渡护理研究"(TCSDS)的卒中患者。TCSDS 的目的是确定中风后从医院到家庭的转变过程中存在的差异。出院时由训练有素的访问员收集 SDOH。在出院、卒中后 30 天和 90 天时对 mRS 进行评估。多叉逻辑回归模型检验了从出院到 30 天和 90 天期间,每项 SDOH 对 mRS 改善或恶化(与无变化相比)的影响:在 1190 名参与者中,中位年龄为 64 岁,42% 为女性,52% 为非西班牙裔白人,91% 为缺血性中风患者。社会支持网络有限者在 30 天后功能下降的几率更大(aOR = 1.39,1.17-1.66),调整年龄和发病至到达时间后,在 90 天后功能下降的几率更大(aOR = 1.50,1.10-2.05)。在进一步调整其他 SDOH 和参与者特征后,结果一致。与配偶/伴侣同住的人在90天后功能衰退的几率降低(aOR = 0.74, 0.57-0.98);然而,更保守的建模方法得出的结果并不一致:研究结果强调了 SDOH 的重要性,特别是在中风后的功能恢复过程中拥有更多的社会网络。
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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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