Abstract 3145: Nationwide Trends in Inpatient Admission for Transient Ischemic Attack from 2005 to 2009
Objective: To characterize admission trends, length of stay, and hospital costs for transient ischemic attacks (TIAs) in the United States over a five year period.
Introduction: Transient ischemic attacks are relatively common, affecting an estimated 200,000 to 500,000 Americans annually. Rates of admission and characteristics of hospitalized patients with suspected or diagnosed TIA are unknown.
Design/Methods: We searched the Nationwide Inpatient Sample (NIS) for adults discharged with a diagnosis of TIA (diagnosis related group 524) between January 1, 2005 and December 31, 2009; this database represents approximately 20% of all inpatient admissions in the United States. Data reviewed included patient demographics, hospital and regional characteristics, length of stay, and costs associated with admission.
Results: Over the five year period, the number of patients hospitalized for TIA did not vary significantly by year or demographics (38,451 per year; mean age 70.5 years; 59.1% female) though the proportions with hypertension (68.8% to 76.2%) and who were admitted to teaching hospitals (30.1% to 38.4%) increased significantly. Elective admissions also decreased over time from 5.0% to 3.4% (P < 0.001). While the proportion of weekend admissions did not vary, it was slightly less than predicted (25.4% vs. predicted 28.6%). The median length of stay declined slightly per year (2005: 2.89 to 2009: 2.53 days) while hospital total charges increased from $14,341 in 2005 to $18,806 in 2009 (average annual increase: 6.2%). Length of stay was not lower at teaching hospitals compared to non-teaching hospitals (2.73 vs. 2.71 days) while costs were higher ($17,753 vs. $15,945, P < 0.001).
Conclusions: Based on these data, we estimate that over 190,000 TIA patients are hospitalized each year in the United States. Despite the common rationale that TIA evaluation is expedited, average length of stay exceeds 2 days and costs exceeded $18,000 per patient in 2009. Teaching hospitals account for an increasing proportion of TIA admissions and are associated with higher costs. Further study is needed on cost-effective strategies (including expedited outpatient evaluation) for TIA patients.
- © 2012 by American Heart Association, Inc.