Author + information
- Yashwant Agrawal,
- Chris Jacob,
- Carleigh Zahn,
- Sourabh Aggarwal,
- Sidakpal Panaich,
- Frank Saltiel,
- Jagadeesh Kalavakunta and
- Vishal Gupta
Background: Ischemic Stroke (IS) is associated with traditional risk factors of diabetes, hypertension, hyperlipidemia and smoking. However, impact of hereditary causes of thrombosis (HT) on IS is largely unknown. HT includes primary hypercoagulable state, activated protein C resistance, antithrombin III deficiency, factor V Leiden mutation, lupus anticoagulant, protein C deficiency, protein S deficiency and prothrombin gene mutation. This study was designed to study the influence on HT on IS in the US from 2008-2012.
Methods: We used Nationwide Inpatient Sample (NIS) to extract data for patients hospitalized with primary diagnosis of IS, corresponding to ICD 9 codes of 434.11, 434.91, 436. HT was identified with ICD 9 code 289.91. NIS represents 20% of all hospital data in US. Data was extracted for the years 2008-2012. Logistic regression models were used to analyze the association between HT and IS.
Results: A total of 2,504,565 weighted discharges were identified with primary/secondary diagnosis of IS of which 20,559 also had HT. Mean age of IS patients with and without HT was 55.5 and 70.9 years, respectively. More females had IS and HT when compared to males (57.0% vs. 43.0%). Likewise, for IS patients without HT, females were predominant (53.5% vs. 46.5%). When controlling for demographics, diabetes and hypertension; estimated odds for a length of stay more than 1 week for IS was 2.00 (95% CI: 1.86, 2.16; p<0.0001) times greater in patients with HT. Similarly, estimated odds for total charges for IS was 1.35 (95% CI: 1.30, 1.41; p<0.0001) times greater in patients with HT. In-hospital mortality for IS was not statistically significant for patients with and without HT (p=0.8715).
Conclusions: This study attempted to characterize the impact of HT on IS. Our study is perhaps the first showing a statistically significant increased length of stay and hospital charges in patients admitted for IS with underlying HT compared to patients without HT. Interestingly, in-hospital mortality was not affected by HT. Interventions need to be directed to prevent increased economic burden and prolonged hospitalization for this group of patients. Further studies are needed to investigate the influence of HT on IS.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Vascular Medicine: Emerging Concepts in Clinical Vascular Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1254-354
- 2017 American College of Cardiology Foundation