OBJECTIVES: As stroke treatment is time-dependent, it challenges the social and demographic context of patients for timely consultation and effective access to reperfusion therapies. The aim of this study was to relate indicators of social position to cardiovascular risk factors, time of arrival, access to reperfusion therapy and mortality in the setting of acute ischemic stroke.

METHODS: Using electronic medical records, we performed a retrospective analysis of all patients with a diagnosis of ischemic stroke in a large university hospital in Bogotá. Patients were characterised according to indicators of social position (years of schooling, housing, employment, and stratum as classified from 1 to 6, with 6 being highest, by government agencies) time of arrival after stroke, reperfusion therapy and in-hospital mortality.

RESULTS: 558 patients (women 319, 57%) were included. Mortality was higher in rural patients (n=8, 14% vs n=30, 6%; p=0.03). Lower schooling (6 years or less) was associated with late consultation (n=30, 15% vs n=59, 29%; p=0.0011) and lower probability of accessing reperfusion therapy (n=12, 6% vs n=45, 22%; p=<0.0001). Formal employment was associated with a visit to the emergency department in less than 3 hours (n=50, 25% vs n=58, 18%, p=0.04 and a higher probability of accessing reperfusion therapy (n=35, 18% vs n=33, 10%; p=0.01. Stratum higher than 3 was associated with early arrival (n=77, 26% vs n=39, 16%; p=0.004) and reperfusion therapy (n=57, 19% vs n=13, 5%; p= <0.0001).

CONCLUSIONS: Indicators of socioeconomic status are related to mortality, consultation time and access to reperfusion therapy. Mortality and reperfusion therapy are inequitably distributed and, therefore, require public policies to reduce the access gap in the context of acute stroke in Bogotá.