To determine the potential prevalence of thrombophilia and its association in cerebral infarction (CI) in a nationwide database, as well as to assess the potential effect of antithrombotic therapy on patients with identified hypercoagulability and CI. 

Thrombophilia raises the risk of venous or arterial intravascular thrombi. It has been linked to an increased risk of stroke.

 We assessed data in terms of prevalence of thrombophilia and its association with CI from the Nationwide Inpatient Sample (NIS) from 2016 to 2018 using ICD code 10. We also looked for the outcome in reference to inpatient mortality, average length of stay (LOS), and discharge to either a rehabilitation center (RC) or a skilled nursing facility (SNF) in the above patients. A P value of <0.05 was considered significant. 

In a total of 21 million patients, the frequency of thrombophilia was 0.6% in all patients compared to 1.2% in cerebral infarct patients. The prevalence of stroke was significantly higher in the group of younger patients <45yo (13.5, 95% CI 12.7 - 14.18, (p <0.001), females (55.9%, p < 0.001)  and Caucasians (68.9% p <0.001 ). The prevalence of cerebral infarct was significantly lower in the anticoagulant group, OR 0.61, CI-0.57-0.66, P<0.001 compared to anti-platelet group, OR 2.2, CI-1.92-2. P<0.001 and without any antithrombotic group , OR 1.40, CI-1.32-1.52, P <0.001. The LOS (8 vs. 5 days, p=0.001) and discharge to either RC or SNF (40% vs. 35%, p=0.003) was higher in the patients without antithrombotic compared to the anticoagulant group.

 There was greater propensity of CI in younger white causations. Patients with hypercoagulability in association with cerebral infarct have a better outcome with anticoagulant therapy than either antiplatelet therapy or no antithrombotic therapy. The worse outcome in the antiplatelet group might reflect a higher risk population for which anticoagulant therapy is not felt to be appropriate or safe.