Outcomes after acute ischemic stroke in the United States: does residential ZIP code matter?

Journal of the American Heart Association
Shikhar AgarwalWael A Jaber

Abstract

We sought to analyze the impact of socioeconomic status (SES) on in-hospital outcomes, cost of hospitalization, and resource use after acute ischemic stroke. We used the 2003-2011 Nationwide Inpatient Sample database for this analysis. All admissions with a principal diagnosis of acute ischemic stroke were identified by using International Classification of Diseases, Ninth Revision codes. SES was assessed by using median household income of the residential ZIP code for each patient. Quartile 1 and quartile 4 reflect the lowest-income and highest-income SES quartile, respectively. During a 9-year period, 775,905 discharges with acute ischemic stroke were analyzed. There was a progressive increase in the incidence of reperfusion on the first admission day across the SES quartiles (P-trend<0.001). In addition, we observed a significant reduction in discharge to nursing facility, across the SES quartiles (P-trend<0.001). Although we did not observe a significant difference in in-hospital mortality across the SES quartiles in the overall cohort (P-trend=0.22), there was a significant trend toward reduced in-hospital mortality across the SES quartiles in younger patients (<75 years) (P-trend<0.001). The mean length of stay in the low...Continue Reading

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Citations

Feb 18, 2016·Risk Analysis : an Official Publication of the Society for Risk Analysis·Richard Denning, Vinod Mubayi
Mar 26, 2016·Journal of the American College of Cardiology·Shikhar AgarwalMehdi H Shishehbor
Dec 9, 2017·Diseases of the Colon and Rectum·Alison R AlthansScott R Steele
Jun 6, 2018·Journal of Urban Health : Bulletin of the New York Academy of Medicine·Brittany D ChambersLaura L Jelliffe-Pawlowski
May 4, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A GuptaA M Merchant
Dec 5, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Sanjana SalwiRohan V Chitale
Feb 16, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Pious D PatelChevis N Shannon
Feb 7, 2018·Journal of the Neurological Sciences·Matthew BlattnerMatthew D Holtkamp

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Software Mentioned

HCUP Clinical Classification Software ( CCS )
Stata

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