Stroke is a leading cause of disability globally. Healthcare disparities exist to variable degrees in different regions, and certain ethnic groups are disproportionately affected. Pre-hospital delays affect stroke outcome. We aim to determine whether area deprivation index was an independent predictor of hospital arrival.

This is a retrospective observational study. A Longitudinal chart review was performed through  the EMR. Stroke patients, over 18 years of age, presenting between 2016 to 2023, and resided in Erie County, NY. So­ciodemographic covariates including age, race or ethnicity, and gender are displayed as frequencies. The Area Deprivation Index (ADI) is a validated score obtained through the Neighborhood atlas for all patients’ 5-digit Zip code.

A binary logistic regression model was constructed to ascertain the effects of age, gender, race, zip code, distance from zip code, Tobacco use, stroke history and national ADI on the likelihood of presenting to the hospital within window.

55 patients are included in this preliminary analysis. 56.4% of patients were males. 32.7% were African American and the majority were white. 96.4% were English speaking. Patients presented from 17 different towns or cities within Erie County. 66% of patients arrived via ambulance. The median age was 74. Median time from last known well (LKW) to Hospital arrival was 5 hours. Median NIHSS was 6.5. Patients living in highly disadvantaged areas were 4 times more likely to present to the comprehensive stroke center outside window when correcting for other variables (p=0.031).

Patients living in highly disadvantaged areas are more likely to present outside window for IV thrombolysis. IV thrombolysis is the current standard of care for ischemic stroke and exclusion from treatment likely impacts long term outcomes. Further studies aimed at understanding the factors influencing late arrival are needed.