Abstract WP189: Trends in Comorbidities Among Stroke-related Hospitalizations in California, 2000-2013
Background: Preventive care for adults with hypertension and diabetes has improved over the recent decade. This study aims to identify trends of these and other comorbidities for patients with stroke-related hospitalizations in California from 2000 to 2013.
Methods: This retrospective study is based on patient discharge information compiled by the California Office of Statewide Health and Planning Development from 2000 to 2013. The study population is comprised of residents, and represents over 31.68 million hospital events. Stroke hospitalizations were identified using the first listed diagnoses in the hospital records, ICD-9-CM codes 430 to 436.
Comorbidities were identified using ICD-9-CM codes in 24 other diagnostic fields in each stroke hospitalization, aided by AHRQ’s Clinical Classification Software.
Cochran Armitage trend test was employed to identify comorbidity trends from 2000 to 2013. Stroke hospitalizations were adjusted for sex, age, race/ethnicity and insurance type using multivariable logistic regression for each of the comorbidities analyzed.
Results: Over 1 million hospitalizations and 77,908 in-hospital mortalities for stroke were identified from 2000 to 2013. Disorders of lipid metabolism among stroke-related hospitalizations rose by 230.5% from 16.7% in 2000 to 55.1% in 2013. Diabetes mellitus increased by 45.1% from 27.0% in 2000 to 39.2% in 2013. Cardiac dysrhythmia rose by 36.6% from 21.0% in 2000 to 28.7% in 2013 while hypertension rose by 22.0% from 67.7% in 2000 to 82.6% in 2013. The trend test showed significant upward trends (p <0.001) for these four comorbidities during the study period.
After adjusting for patient demographics and insurance type, all four comorbidities had a positive association with stroke-related hospitalizations: diabetes mellitus (AOR 1.247; 95% CI=1.228-1.267), hypertension (AOR 2.685;[95% CI=2.631-2.740), disorders of lipid metabolism (AOR 2.095; 95% CI=2.063-2.127) and cardiac dysrhythmias (AOR 1.193; 95% CI=1.172-1.213).
Conclusion: Diabetes mellitus, hypertension, disorders of lipid metabolism and cardiac dysrhythmia are positively associated with stoke-related hospitalizations.
Author Disclosures: A.W. Ratnasiri: None. B.M. Ratnasiri: None. R. DiLibero: None.
- © 2016 by American Heart Association, Inc.