Poor Social Determinants of Health Negatively Affect Functional Outcomes in Hemorrhagic Stroke
MONDAY, June 23, 2025 -- For patients with intracerebral hemorrhage (ICH), significant disparities in functional outcomes and survival rates are associated with social determinants of health (SDoH), according to a study published online June 18 in Neurology Clinical Practice.
Tatiana Abou-Mrad, M.D., from the University of Illinois at Chicago, and colleagues conducted a retrospective study using the MARINER165 national administrative database to examine the impact of SDoH on the prognosis and clinical outcomes of patients with ICH. Data were included for 481,754 patients with ICH: 240,877 in each of two cohorts based on SDoH presence after propensity score matching.
The researchers observed pronounced disparities in food security, social integration, and physical environment for the SDoH group (87, 14.2, and 8.3 percent, respectively). This group experienced worse functional outcomes at 30 days, including higher rates of tracheostomy (2 versus 0.9 percent) and G-tube placement (3.2 versus 1.5 percent), increased wheelchair dependency (3.2 versus 2.5 percent), lower mobility scores (3.5 versus 2.7 percent), and higher readmission rates (9.8 versus 6.2 percent). Despite these challenges, at both 90 days and one year, the SDoH group demonstrated better survival rates (78.1 versus 72.6 percent and 62.1 versus 57.6 percent, respectively).
"Our study found certain social disparities negatively impacted recovery after a bleeding stroke; yet surprisingly, these same factors were tied to a higher rate of survival, which reflects the complex connection between social factors and health outcomes," coauthor Fady T. Charbel, M.D., also from the University of Illinois, said in a statement.
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