Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
Tasmanian School of Medicine, Rural Clinical School, University of Tasmania, Burnie, Australia.
Health Qual Life Outcomes. 2023 Oct 25;21(1):115. doi: 10.1186/s12955-023-02194-y.
Socioeconomic status (SES) is associated with stroke occurrence and survival following stroke but its association with health-related quality of life (HRQoL) following stroke remains uncertain. We performed a systematic review and meta-analysis to examine the association between SES and HRQoL after stroke.
PubMed, SCOPUS, EMBASE, and Web of Science were searched to identify relevant cohort and case-control studies between January 2000 and May 2022. Two authors screened titles, abstracts and full text articles. One author extracted data from all included studies. Meta-analyses were performed for studies with comparable measurements of SES and HRQoL. Random effects models were used to estimate pooled summary standardised mean differences in HRQoL by SES.
Out of 1,876 citations, 39 studies incorporated measurement of overall HRQoL following stroke and were included in the systematic review, with 17 studies included in the meta-analyses. Overall, reports including education, income, occupation and work status effects on HRQoL after stroke were inconsistent among all included 39 studies. In the global meta-analysis of 17 studies, HRQoL among survivors of stroke was lower in the low SES group than in the high SES group (standardised mean difference (SMD) -0.36, 95% CI -0.52, -0.20, p < 0.0001). When using education and income indicators separately, summary effects were similar to those of the global analysis (low versus high education SMD -0.38, 95% CI -0.57, -0.18, p < 0.0001; low versus high income SMD -0.39, 95% CI -0.59, -0.19, p < 0.0001).
Across all SES indicators, people with stroke who have lower SES have poorer overall HRQoL than those with higher SES. Accessibility and affordability of poststroke support services should be taken into consideration when planning and delivering services to people with low SES.
社会经济地位（SES）与中风发生和中风后生存有关，但它与中风后健康相关生活质量（HRQoL）的关系尚不确定。我们进行了系统评价和荟萃分析，以检查 SES 与中风后 HRQoL 之间的关系。
检索 2000 年 1 月至 2022 年 5 月期间的 PubMed、SCOPUS、EMBASE 和 Web of Science，以确定 SES 和 HRQoL 之间具有可比性的队列和病例对照研究。两位作者筛选标题、摘要和全文文章。一位作者从所有纳入的研究中提取数据。对 SES 和 HRQoL 具有可比测量值的研究进行荟萃分析。使用随机效应模型估计 SES 对 HRQoL 的汇总标准均数差。
在 1876 条引文中有 39 项研究纳入了中风后总体 HRQoL 的测量，这些研究被纳入了系统评价，其中 17 项研究被纳入了荟萃分析。总体而言，在所有纳入的 39 项研究中，关于教育、收入、职业和工作状况对中风后 HRQoL 的影响的报告不一致。在包括 17 项研究的全球荟萃分析中，与 SES 较高的组相比，中风幸存者的 HRQoL 较低（标准均数差（SMD）-0.36，95%CI-0.52，-0.20，p<0.0001）。当单独使用教育和收入指标时，综合效果与全球分析相似（低与高教育 SMD-0.38，95%CI-0.57，-0.18，p<0.0001；低与高收入 SMD-0.39，95%CI-0.59，-0.19，p<0.0001）。
在所有 SES 指标中，SES 较低的中风患者整体 HRQoL 较差于 SES 较高的患者。在为 SES 较低的患者规划和提供服务时，应考虑到中风后支持服务的可及性和可负担性。
