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Trends in hospitalizations and cost associated with stroke by age, United States 2003-2012.
Int J Stroke. 2016 10; 11(8):874-881.IJ

Abstract

Background The disease burden associated with stroke by age is not well known. Aim To assess the trends in stroke hospitalizations and associated cost among adults aged ≥18 years by age groups in the United States. Methods The study population consisted of 2003-2012 adult hospitalizations from the National Inpatient Sample of the Healthcare Cost and Utilization Project. Subarachnoid hemorrhage, intracerebral hemorrhage, and acute ischemic stroke hospitalizations were identified by the principal diagnosis ICD-9-CM code. We estimated national hospitalization rates and inflation-adjusted hospital costs across five consecutive 2-year time intervals, stratified by seven age groups. Results Hospitalization rates for subarachnoid hemorrhage decreased significantly from 2003-2004 to 2011-2012 for ages 35-44 (relative percent change (RPC): -23%) and 45-54 (RPC: -22%), respectively. For intracerebral hemorrhage, the rates decreased significantly for ages ≥65 years. Acute ischemic stroke hospitalization rates increased significantly for ages 18-54 and decreased significantly for ages 65-84 years. The average per-hospitalization cost for subarachnoid hemorrhage increased 7-35% among all age groups, except those aged 65-74, and increased 10-29% for intracerabral hemorrhage except those aged 75-84, and increased 6-19% among all ages for acute ischemic stroke, respectively. Overall, the estimated total national cost increased 7% for subarachnoid hemorrhage, 10% for intracerebral hemorrhage, and 18% for acute ischemic stroke from 2003-2004 to 2011-2012. Conclusions From 2003 to 2012, subarachnoid hemorrhage and intracerabral hemorrhage stroke hospitalization rates declined across all age groups. While US acute ischemic stroke hospitalizations among ages 65-84 declined significantly, the hospitalization rates increased significantly among ages 18-54. The estimated hospital costs increased across all stroke subtypes during the study period.

Authors+Show Affiliations

Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27312679

Citation

Tong, Xin, et al. "Trends in Hospitalizations and Cost Associated With Stroke By Age, United States 2003-2012." International Journal of Stroke : Official Journal of the International Stroke Society, vol. 11, no. 8, 2016, pp. 874-881.
Tong X, George MG, Gillespie C, et al. Trends in hospitalizations and cost associated with stroke by age, United States 2003-2012. Int J Stroke. 2016;11(8):874-881.
Tong, X., George, M. G., Gillespie, C., & Merritt, R. (2016). Trends in hospitalizations and cost associated with stroke by age, United States 2003-2012. International Journal of Stroke : Official Journal of the International Stroke Society, 11(8), 874-881. https://doi.org/10.1177/1747493016654490
Tong X, et al. Trends in Hospitalizations and Cost Associated With Stroke By Age, United States 2003-2012. Int J Stroke. 2016;11(8):874-881. PubMed PMID: 27312679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in hospitalizations and cost associated with stroke by age, United States 2003-2012. AU - Tong,Xin, AU - George,Mary G, AU - Gillespie,Cathleen, AU - Merritt,Robert, Y1 - 2016/07/09/ PY - 2016/6/18/pubmed PY - 2017/10/7/medline PY - 2016/6/18/entrez KW - Hospitalization rate KW - acute ischemic stroke KW - intracerebral hemorrhage stroke KW - subarachnoid hemorrhage stroke KW - trends SP - 874 EP - 881 JF - International journal of stroke : official journal of the International Stroke Society JO - Int J Stroke VL - 11 IS - 8 N2 - Background The disease burden associated with stroke by age is not well known. Aim To assess the trends in stroke hospitalizations and associated cost among adults aged ≥18 years by age groups in the United States. Methods The study population consisted of 2003-2012 adult hospitalizations from the National Inpatient Sample of the Healthcare Cost and Utilization Project. Subarachnoid hemorrhage, intracerebral hemorrhage, and acute ischemic stroke hospitalizations were identified by the principal diagnosis ICD-9-CM code. We estimated national hospitalization rates and inflation-adjusted hospital costs across five consecutive 2-year time intervals, stratified by seven age groups. Results Hospitalization rates for subarachnoid hemorrhage decreased significantly from 2003-2004 to 2011-2012 for ages 35-44 (relative percent change (RPC): -23%) and 45-54 (RPC: -22%), respectively. For intracerebral hemorrhage, the rates decreased significantly for ages ≥65 years. Acute ischemic stroke hospitalization rates increased significantly for ages 18-54 and decreased significantly for ages 65-84 years. The average per-hospitalization cost for subarachnoid hemorrhage increased 7-35% among all age groups, except those aged 65-74, and increased 10-29% for intracerabral hemorrhage except those aged 75-84, and increased 6-19% among all ages for acute ischemic stroke, respectively. Overall, the estimated total national cost increased 7% for subarachnoid hemorrhage, 10% for intracerebral hemorrhage, and 18% for acute ischemic stroke from 2003-2004 to 2011-2012. Conclusions From 2003 to 2012, subarachnoid hemorrhage and intracerabral hemorrhage stroke hospitalization rates declined across all age groups. While US acute ischemic stroke hospitalizations among ages 65-84 declined significantly, the hospitalization rates increased significantly among ages 18-54. The estimated hospital costs increased across all stroke subtypes during the study period. SN - 1747-4949 UR - https://www.unboundmedicine.com/medline/citation/27312679/Trends_in_hospitalizations_and_cost_associated_with_stroke_by_age_United_States_2003_2012_ L2 - https://journals.sagepub.com/doi/10.1177/1747493016654490?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -