Abstract Details

Title Predictive Risk Factors of In-Hospital Mortality Following Acute Stroke in the United States: Data from the Nationwide Inpatient Database, 2006-2010

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 015

Objective

Background BACKGROUND: Stroke is the fourth leading cause of death in the United States after heart disease, cancer and chronic lower respiratory disease. Knowledge of the risk factors of mortality in stroke patients may aid clinicians to contribute to a reduction of mortality.

Design/Methods DESIGN/METHODS: Using the National Inpatient Sample database, we examined the clinical data of patients who admitted for acute stroke in 2006-2010 in the US. Patients with transient ischemic attack (TIA) were excluded from this study. Multivariate regression analysis was performed to identify factors predictive of in-hospital mortality.

Results RESULTS: A total of 2,567,100 patients admitted with diagnosis of acute stroke during this period (Ischemic:82.34% vs. hemorrhagic:17.66%). Overall rate of in-hospital mortality was 8.42% (ischemic:5.43% vs. hemorrhagic:22.35%; p<0.001). Using multivariate regression analysis, hemorrhagic stroke (adjusted odds ratio [AOR]: 4.89), hyperhomocysteinemia (AOR:4.70). hyperlipidemia (AOR:1.90), congestive heart failure (AOR,1.49), age over 65 (AOR:1.42), chronic kidney disease (AOR:1.31), liver disease (AOR:1.31) and cocaine use (AOR,1.22), were associated with higher risk of in-hospital mortality. Although Caucasian race (AOR:1.15), male sex (AOR:1.11), coronary artery disease (AOR:1.09), teaching hospital (AOR:1.09), peripheral vascular disease (AOR:1.07), chronic lung disease (AOR:1.04), and alcohol abuse (AOR:1.04) also had statistically significant impact on in-hospital mortality, these were less clinically significant than the other factors. There was no association with hypertension, diabetes, smoking, atrial fibrillation/flutter, obesity, hypercoagolupathy, history of venous thromboembolism or history of TIA and in-hospital mortality.

Conclusions CONCLUSIONS: The rate of in-hospital mortality is relatively high following acute stroke (8.42%). We identified multiple risk factors of in-hospital mortality in acute stroke patients. The strongest risk factor is the type stroke (hemorrhagic). The present finding suggests that patients at increased risk of mortality can be identified and additional treatment for prevention might be warranted.

Authors/Disclosures
Nassim Naderi, MD (Medsurant monitoring) PRESENTER	No disclosure on file
Hermelinda Abcede, MD (TeleSpecialists, LLC)	Dr. Abcede has nothing to disclose.
Lama Al-Khoury, MD (University of Riverside (UCR))	Dr. Al-Khoury has nothing to disclose.
Tahseen Mozaffar, MD, FAAN (University of California Irvine)	Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Mozaffar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Mozaffar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amicus. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Grifols. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Astellas Gene Therapy. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Mozaffar has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta. Dr. Mozaffar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Therapeutics. The institution of Dr. Mozaffar has received research support from NIH. The institution of Dr. Mozaffar has received research support from Muscular Dystrophy Association. The institution of Dr. Mozaffar has received research support from Sanofi. The institution of Dr. Mozaffar has received research support from Argenx. The institution of Dr. Mozaffar has received research support from Amicus Therapeutics. The institution of Dr. Mozaffar has received research support from Astellas Gene Therpay. The institution of Dr. Mozaffar has received research support from Cartesian. The institution of Dr. Mozaffar has received research support from Cabaletta. Dr. Mozaffar has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH.
Vivek Jain, MD	No disclosure on file
John Q. Trojanowski, MD, PhD (University of PA School of Med)	Dr. Trojanowski has nothing to disclose.

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