Rural-Urban Differences in Stroke Types, Risk Factors, Severity and Prognosis in Babol, Northern Iran

Abstract

Introduction: Stroke recognized as the third most common cause of death. Stroke survivors often suffer a large amount of physical and mental disability. Due to assess difference between stroke types, progression and distribution of risk factors according to residential status, to get the correct information for prevention planning and management, this study was conducted.

Methods: This descriptive cross-sectional study on stroke patient from 2016 to 2017 that admitted to Ayatollah Rohani Hospital of Babol was conducted. Type of stroke, their severity, risk factors, and urban or rural area of residence of patients were recorded in the checklist. The chi-square test was used to compare frequencies of gender, and stroke risk assessment between the urban and rural residents. Binary logistic regression modeling was used to estimate the association of risk factors with living in urban and rural areas. The results were expressed as multivariable-adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs). A two-sided p < 0.05 was considered statistically significant. All data analyses were performed, using SPSS statistical analysis software.

Results: Of 241 stroke patients, 133 patients (55 %) were female and 213 patients (88.4 %) were  ischemic.  Also,  140 cases were (58  %)  rural.  Embolic strokes more in urban population and thrombotic strokes were more in rural populations. Hyperlipidemia was more in urban than rural p = 0.01. Severity of stroke in admission time (p = 0.03) and at discharge (p = 0.005) was more in rural than urban. The mortality was higher in rural 12 (8.6) vs. 2 (2) urban resident,( p = 0.03).

Conclusion: Rural patients had more severity, thrombotic type and mortality than urban. Suitable policy regard to residential parameter is suggested.