Abstract TP133: Impact of Proximity to Certified Stroke Centers on Stroke Outcomes and Risk Profiles in the United States

Geographic disparity in stroke is well researched, with consensus being that greater distance from a certified stroke center (SC) is associated with worse outcomes. The extent to which geographic access interacts with other stroke risk factors remains unclear. This study investigates the impact of SC proximity on various comorbidity risk factors and stroke outcomes across the United States. This study analyzed 3,068 U.S. counties and 2,460 certified SCs. Data from the CDC Atlas of Heart Disease and Stroke and EMNet’s findERnow database informed this study. Metrics included distance from the center of a county to the nearest SC, stroke prevalence and mortality (per 100,000 people), comorbidity, and health utilization rates. Gamma regression was used to analyze across continuous distance and ordinal regression was used for categorized ranges. Both ischemic (RR 0.90, 95% CI [0.89, 0.92]; P