Abstract TMP73: Factors Associated with Length of Hospitalization in Patients Admitted with Transient Ischemic attack
Background: Approximately 70% of all patients presenting with transient ischemic attack (TIA) are admitted to the hospital in United States. The duration and cost of hospitalization and associated factors are poorly understood. We performed this analysis to identify the proportion and determinants of prolonged hospitalization and to determine the impact on hospital charges using nationally representative data.
Methods: We determined the national estimates of length of stay, mortality, and charges incurred in patients admitted with TIA (Diagnosis related code 524) using Nationwide Inpatient Survey (NIS) data from 2002 to 2010. NIS is the largest all-payer inpatient care database in the United States and contains data from 986 hospitals approximating a 20-percent stratified sample of U.S. community hospitals. All the variables pertaining to hospitalization were compared in three groups based on length of hospital stay (<1 day, 2-6 days, and ≥7 days).
Results: A total of 949,558 patients were admitted with the diagnosis of TIA during the study period. The length of hospitalization was <1 day, 2-6 days, and ≥7 days in 232732 (24.4%), 662909 (70) %), and 53917 (5.6%) patients respectively. The mean hospitalization charges (95% confidence interval) were $ 8,348 (8123-8572), $14,471(14030-14911), and $34,035 (32280-35790) for patients hospitalized for <1 day, 2-6 days, and ≥7 days, respectively. The rates of atrial fibrillation (8.3%, 13.1%, and 22.6%, p<.0001), congestive heart failure (1.1%, 1.9%, and 3.7%, p<.0001), chronic lung disease (11.4%, 14.7%, and 20.0%, p<.0001), coagulopathy (0.8%, 1.3%, and 2.7%, p<.0001) and renal failure (3.1%, 5.1%, and 11.7%, p<.0001) were associated with length of hospitalization. The use of thrombolytics (0.03%, 0.09%, and 0.1%, p<.0001) for ischemic stroke was very low among the three strata defined by length of hospitalization.
Conclusions: Approximately 75% of patients admitted with TIA stay in the hospital for 2 or more days with the most important determinants being pre-existing medical co-morbidities. Longer duration of hospital stay is associated with 2-5 fold greater hospitalization cost.
- © 2012 by American Heart Association, Inc.