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Functional outcomes and mortality rates for ischemic stroke patients presenting to rural hospitals or urban hospitals in Pennsylvania

Siddiqui, Hinnah (2019) Functional outcomes and mortality rates for ischemic stroke patients presenting to rural hospitals or urban hospitals in Pennsylvania. Master Essay, University of Pittsburgh.

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Abstract

Stroke is the fifth leading cause of death in the United States and is a major public health concern worldwide. Most strokes are caused when clots form in a vessel and block blood flow. Tissue plasminogen activator (tPA) can be used to dissolve the clot quickly. Most debilitating strokes are caused by large vessel occlusion (LVO). Patients in rural areas often lack timely access to specialty stroke care, thus transfer to tertiary hospitals may be necessary to access time-sensitive endovascular therapies (ET) needed for LVO. We hypothesized that stroke patients from rural areas in Pennsylvania would have decreased functional outcome and higher mortality rates compared to those from urban areas. Data were collected on patients in a large regional health system with confirmed ischemic stroke from January 2014 to December 2015. Rural hospitals were defined as those located in counties designated as rural by the Center for Rural Pennsylvania. Time to intervention, mortality, and functional outcome measured by the modified Rankin scale (mRS), were compared between rural and urban centers. Results of the study showed that stroke patients discharged from rural hospitals do not have more severe functional outcomes or higher mortality rates. Thus, there is no significant difference in outcome measures between rural and urban hospitals among an integrated health delivery system (UPMC) in Western Pennsylvania.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Siddiqui, Hinnahhis18@pitt.eduHIS18
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairBarinas-Mitchell, Emmabarinas@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberGuyette, Francisguyefx@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberMartin-Gill, Christianmartingillc@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: December 2019
Date Type: Submission
Number of Pages: 39
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 20 Aug 2020 18:13
Last Modified: 20 Aug 2020 18:13
URI: http://d-scholarship.pitt.edu/id/eprint/37849

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