DOI: 10.1161/str.55.suppl_1.wmp60 ISSN: 0039-2499

Abstract WMP60: Comparison of Demographic and Clinical Characteristics and the CDC Social Vulnerability Index Among Medicare Beneficiaries Hospitalized With Acute Ischemic Stroke, April 2020 - December 2021

Xin Tong, Elena V Kuklina, Robert K Merritt
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)

Introduction: Extensive evidence shows that social inequities create health disparities. However, limited information exists on how demographic and clinical factors are associated with social inequities among older patients hospitalized with acute ischemic stroke (AIS) during COVID-19.

Methods: We analyzed data on Medicare fee-for-service beneficiaries aged ≥65 years hospitalized with AIS from April 1, 2020, to December 31, 2021. All patients were followed until March 31, 2023. We used US Centers for Disease Control and Prevention’s 2020 Social Vulnerability Index (SVI) and compared demographic and clinical features by SVI tertiles (low 0-0.33, moderate 0.34-0.66, high 0.67-1.0).

Results: Among 249299 Medicare FFS beneficiaries with AIS, there were 57814 (23.2%) with low, 88565 (35.5%) moderate, and 102920 (41.3%) high SVI. Demographic and clinical features differed significantly across SVI tertiles. Compared to AIS patients living in low SVI communities, patients living in high SVI areas were significantly younger (median age 79.0 vs 79.9 years), more likely to be non-Hispanic Black (15.4% vs 4.3%), had more severe stroke at admission per National Institutes of Health Stroke Scale (NIHSS) score (9.4% NIHSS ≥20 vs 8.4%), more history of COVID-19 (7.7% vs 6.3%), higher proportion of death at the end of follow-up (40.4% vs 38.2%), and more comorbidities.

Conclusion: Medicare patients with AIS hospitalizations live in communities with higher SVI. These data identified racial disparities and more severe outcomes among AIS patients living in areas with higher social vulnerabilities, signaling a need for multisectoral interventions and policies that impact AIS outcomes.

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