Socioeconomic factors influence stroke surgery outcomes in coal mining areas

Research presented today at the Society of NeuroInterventional Surgery’s (SNIS) 21^st The annual meeting will highlight the role of socio-economic variables and their role in successful recovery from stroke, particularly the impact of living in a mining area.

Strokes are most often caused by a major artery occlusion, a blood clot that blocks a major blood vessel and significantly cuts off blood flow to the brain. Thrombectomy, a minimally invasive procedure that uses a catheter to reopen the blocked artery, is the gold standard for treating this type of stroke. In their study, “Living in Coal Mining Areas Significantly Worsens Outcomes in Following Mechanical Thrombectomy for Acute Ischemic Stroke,” researchers from the University of Kentucky reviewed medical records of all patients who underwent a thrombectomy at a Kentucky hospital between 2015 and 2022. Patients were stratified by county, with coal mining status as the primary variable. Data on median income, rurality, food insecurity, and mental and physical disability were also examined using county census data. This was used to evaluate the social determinants of patient health, nonmedical factors that can affect an individual’s health.

The researchers found that residents of coal mining counties had lower median incomes, were more likely to live in rural areas, and were more likely to have physical and mental health conditions than other residents. In addition, residents of coal counties were more likely to be food insecure, had less access to a primary care provider, and were generally significantly further away from health care facilities.

The analysis also found that the time between stroke and thrombectomy was longer among Coal County residents (599.8 minutes versus 454.8 minutes) and that scores on the NIH Stroke Scale (which measures brain function after stroke) were worse in the hospital and after discharge.

Researchers concluded that while thrombectomy is effective, patients from disadvantaged backgrounds still experience poorer outcomes due to underlying health conditions.

“Many non-medical factors can influence whether and how you recover from a stroke,” said Zahraa Al-Sharshahi, MD, a neurosurgeon in training at the University of Kentucky and the study’s lead author. “It is critical to understand the importance of comprehensive care strategies that go beyond acute treatment so that we can achieve optimal health for all.”