Research presented today on the twenty first Conference of the Society of Neurointerventional Surgery (SNIS)^saint The annual meeting highlights the role of socio-economic variables and their importance in successful recovery from stroke, particularly the impact of living in a mining district.

Strokes are most frequently brought on by large-vessel occlusion, a blood clot that blocks a big blood vessel, cutting off significant 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 any such stroke. Of their study, “Living in Coal-Mining Areas Significantly Worsens Outcomes After Mechanical Thrombectomy for Acute Ischemic Stroke,” researchers from the University of Kentucky reviewed the medical records of all patients who underwent thrombectomy at a single Kentucky hospital between 2015 and 2022. Patients were divided into groups by county, with coal-mining status as a baseline variable. Data on median income, rurality, food insecurity, and mental and physical disability were also analyzed from county census data. They were used to evaluate patients’ social determinants of health, nonmedical aspects that may affect a person’s health.

The researchers found that residents of mining counties had lower average incomes, were more prone to live in rural areas, and were more prone to suffer from physical and mental health problems than other residents. As well as, residents of mining counties were more prone to experience food insecurity, had less access to primary health care, and usually lived much farther from health care facilities.

The evaluation also found that residents of Mining County had an extended time from stroke to thrombectomy (599.8 minutes versus 454.8 minutes) and scores on the NIH Stroke Scale (a measure of brain function after stroke) were worse within the hospital and after discharge.

The researchers concluded that although thrombectomy is effective, patients from disadvantaged backgrounds still have a poorer prognosis attributable to co-occurring health problems.

Many nonmedical aspects can impact whether and the way you get well from stroke. It is crucial to know the importance of comprehensive care strategies beyond acute care in order that we will achieve optimal health for all.

Zahraa Al-Sharshahi, MD, PhD, neurosurgery resident on the University of Kentucky and lead creator of the study