Effect of deprivation and gender on the incidence and management of acute brain disorders

M. R. Macleod*, P. J.D. Andrews

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the impact of deprivation and gender on the incidence and emergency management of acute brain disorders. Design: Retrospective database review of mortality, hospital discharge, and ICU discharge data. Setting: Lothian Health Board area, 1995-1999. Patients and participants: All persons over the age of 15 dying or being discharged from hospital with a primary diagnosis of stroke, epilepsy, subarachnoid haemorrhage (SAH) or traumatic brain injury; patients registered in the Scottish Intensive Care Society Audit Database as having been discharged from the supraregional neurosciences intensive care unit with one of these as a primary diagnoses and a home postcode within the Lothian Health Board area. Measurements and results: Standardised ratios were calculated for hospital admission, mortality, and ICU admission by deprivation category and gender. Data were available for 29,205 hospital admissions, 5,227 deaths, and 360 ICU admissions. For all diagnoses, deprivation was associated with higher rates of hospital admission and death. Deprivation was associated with lower rates of ICU admission for traumatic brain injury and stroke. There was a U-shaped relationship between deprivation and ICU admission with epilepsy. There were no gender differences in rates of ICU admission. Males had higher rates of hospital admission for all conditions and of death from epilepsy and SAH, and lower rates of death from stroke. Conclusions: We have demonstrated deprivation- and gender- differences in the incidence and emergency management of four acute brain disorders. The identification of the source(s) of these differences is an important subject for further research.

Original languageEnglish
Pages (from-to)1729-1734
Number of pages6
JournalIntensive Care Medicine
Volume28
Issue number12
DOIs
Publication statusPublished - 2002

Keywords

  • Health care rationing
  • Intensive care units
  • Nervous system diseases
  • Patient care management
  • Poverty
  • Socioeconomic factors

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