Abstract TP175: Impact of Living Alone on Stroke Outcomes: Results from the Registry of the Canadian Stroke Network

Abstract

Background: Social isolation is a risk factor for poor health outcomes and living alone is a commonly used proxy measure for social isolation. We examined the relationships between living alone and stroke outcomes in patients enrolled in the Registry of the Canadian Stroke Network. Methods: Between 2003-2008, 24526 patients with ischemic stroke, hemorrhagic stroke, or TIA were admitted to 11 Ontario registry hospitals. Patients not living at home (n= 7364), repeat stroke admissions (n=1246) or with missing data (n= 1946) were excluded. Outcomes included onset to arrival time ≤2.5 hrs, discharge to home, mortality (in-hospital, 30-day, 1-year, 3-year), and readmission (1-year). The independent effects of living alone on outcomes were determined using multivariable logistic regression. Results: Overall, 22.5% (n= 3146/13970) of patients were living alone at home prior to admission. Compared to patients living at home with others, patients living alone were significantly more likely to be ≥80 years of age (41.6% vs. 28.8%), female (62.7% vs. 41.4%), white (58.9% vs. 53.7%), widowed (53.5% vs. 11.5%), or single (21.7% vs. 3.7%), and significantly less likely to have diabetes (21.8% vs. 24.8%) or dyslipidemia (32.2% vs. 37.3%). The prevalence of severe stroke was similar (12.4% vs. 14.9%). Patients living alone were less likely to arrive ≤2.5 hrs after onset (32.9% vs. 42.7%) or be discharged to home (61.1% vs. 68.2%), however, differences in mortality or readmission rates were minimal (Table). Adjustment for confounding variables did not appreciably change these results. Conclusions: Patients living alone had delayed hospital arrival and were less likely to return home, but were not at increased risk of death or readmission. Further research is needed to understand the inter-relationships between living alone, social isolation, and poor stroke outcomes, especially given the increasing prevalence of living alone in developed countries.