Abstract W P342: The Effect of Risk Factors on Mortality and Length of Stay in 547 Acute Stroke and Transient Ischemic Attack Patients Treated at a Los Angeles Primary Stroke Center in 2012
Background and Purpose: Multiple clinical risk factors are associated with increased mortality and increased length of stay in stroke patients. The purpose of the study was to examine the effect of clinical risk factors [hypertension (HTN), carotid stenosis, atrial fibrillation, coronary artery disease, depression, smoking, diabetes mellitus (DM), hyperlipidemia, and seizure] and rt-PA (recombinant tissue plasminogen activator) treatment on length of stay (LOS) and mortality. Methods: A retrospective medical record review of all acute stroke and transient ischemic attack (TIA) patients treated in 2012 at a primary stroke center in Los Angeles was conducted. Stroke program patient lists were matched against International Classification of Disease, 9th Edition (ICD-9) codes for 434.91, 431, 430, 435, 435.8, and 435.9. Patients that appeared on both lists were included in the study.Data were analyzed using poisson regression to model the effect of rt-PA and clinical risk factors on LOS. Binary logistic regression was used to examine the effect of rt-PA treatment on mortality. Probability value <0.0001 was considered statistically significant. Results: The total sample size included 547 patients treated for ischemic, hemorrhagic stroke and TIA. Non-tPA ischemic strokes comprised 240 (43.8%) patients in the sample, ischemic strokes treated with tPA totaled 62 (11.3%), ICH patients totaled 133 (24.3%) and TIAs totaled 112 (20.4%). Receiving rt-PA is significant (p<.0001) with a higher number of days in the hospital with a mean stay of 9.03 days versus non-tPA ischemic strokes with a mean stay of 3.12 days. Receiving rt-PA was not associated with increased mortality rate; mortality rate for rt-PA receiving patients was 3%. Diabetes mellitus and HTN were both significant clinical risk factors (p<.0001) for increased LOS, while the other clinical risk factors were not. Conclusions: Presence of HTN, DM, and receiving tPA were associated with longer LOS. Receiving r-tPA was not associated with increased mortality. This study demonstrates the safety of rt-PA treatment in this ischemic stroke population and the importance of prevention and treatment of stroke risk factors such as HTN and DM.
Author Disclosures: J. Garland: None. A. Antonio: None. C. Amara: None. C. Daley: None. A. Liu: None.
- © 2015 by American Heart Association, Inc.